Open AccessTolcapone in obsessive-compulsive disorder: a randomized double-blind placebo-controlled crossover trial
Author(s) -
Jon E. Grant,
Roxanne Hook,
Stephanie Valle,
Eve Chesivoir,
Samuel R. Chamberlain
Publication year - 2021
Publication title -
international clinical psychopharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.559
H-Index - 91
eISSN - 1473-5857
pISSN - 0268-1315
DOI - 10.1097/yic.0000000000000368
Subject(s) - placebo , crossover study , catechol o methyl transferase , psychology , randomized controlled trial , dopaminergic , medicine , psychiatry , anesthesia , dopamine , chemistry , alternative medicine , pathology , allele , biochemistry , gene
Despite the availability of evidence-based treatments for obsessive-compulsive disorder (OCD), not all patients experience sufficient benefit or are able to tolerate them. Tolcapone is a catechol-O-methyl-transferase (COMT) enzyme inhibitor that augments cortical dopaminergic transmission. Conduct a proof of concept study to examine whether a COMT inhibitor would reduce OCD symptoms to a greater extent than placebo. We conducted a randomized, placebo-controlled, double-blind crossover trial in adults with OCD (N = 20). Participants were assessed at baseline, after 2 weeks of tolcapone, and again after 2 weeks of placebo on measures of OCD symptom severity and psychosocial functioning. There was a 1-week washout period between the 2-week treatment phases. Two weeks of tolcapone was associated with significant improvement in OCD versus two weeks of placebo (t = 2.194, P = 0.0409). The mean percentage decreases in the total Yale-Brown obsessive-compulsive scale (YBOCS) scores for the entire sample over the corresponding 2-week period were 16.4% for tolcapone and 3.6% for placebo. These data indicate that brain penetrant COMT inhibitors merit further investigation as a candidate new treatment for OCD.