The new treatment method of obsessive-compulsive disorder: Glutamatergic agents

2022 Fiscal Year Final Research Report

• Project/Area Number: 18K15523
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52030:Psychiatry-related
• Research Institution: Kyoto Prefectural University of Medicine
• Principal Investigator: Yoshinari Abe 京都府立医科大学, 医学(系)研究科(研究院), 助教 (50803631)
• Project Period (FY): 2018-04-01 – 2023-03-31
• Keywords: 強迫症 / Nアセチルシステイン / グルタミン酸 / MRI

Outline of Final Research Achievements

Concerning obsessive-compulsive disorder (OCD), the more detailed understandings of the pathophysiology and the more effective treatment methods are needed due to the poor outcomes of the present evidenced treatment strategies. N-acetylcysteine (NAC) is expected as a new therapeutic agent of OCD which modulates the glutamatergic neurons, while the details of its mechanisms are unclear. In the present study, 12-week treatment with NAC was provided for the patients with OCD, and we acquired MR images and serum concentrations of glutamate before and after the treatment to clarify the function of NAC. NAC improved OC symptoms and elevated the glutamate concentrations significantly, although it did not alter the structural MR images. The diffusion weighted images and the functional images are now under analysis.

Free Research Field

強迫症の認知行動療法、薬物療法と脳画像研究

Academic Significance and Societal Importance of the Research Achievements

NACの作用機序が明らかになることで、新たな作用機序のOCDの治療薬・治療法を開発できる可能性があり、またOCDに関連する他の精神疾患（強迫症関連症群に加えて摂食障害や依存症など）の治療法開発につながる可能性もある。
NACは副作用がほとんどなく、さらに他のグルタミン酸系薬剤として治療効果の期待されているメマンチンの常用量（20 mg）の薬価が439.70円であるのに対してNACの常用量（2400 mg）の薬価は50～100円程度で安価である。新たな選択肢として、NACによる効果メカニズムが明らかになれば強迫症の治療が大きく前進する。