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Pharmacological augmentation of serotonin reuptake inhibitors in patients with obsessive–compulsive disorder: A network meta‐analysis.

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Title: Pharmacological augmentation of serotonin reuptake inhibitors in patients with obsessive–compulsive disorder: A network meta‐analysis.
Authors: Maiti, Rituparna (AUTHOR), Mishra, Archana (AUTHOR), Srinivasan, Anand (AUTHOR), Mishra, Biswa Ranjan (AUTHOR)
Source: Acta Psychiatrica Scandinavica. Jul2023, Vol. 148 Issue 1, p19-31. 13p. 2 Diagrams, 1 Chart, 2 Graphs.
Subjects: Serotonin uptake inhibitors, Obsessive-compulsive disorder, Clinical trial registries, Independent variables, Lennox-Gastaut syndrome, Treatment duration, Alpha 1-antitrypsin deficiency
Abstract: Objectives: The augmentation of serotonin reuptake inhibitors (SRIs) can be achieved by add‐on therapy with different pharmacological agents in obsessive–compulsive disorder (OCD) for a better clinical outcome. This network meta‐analysis (NMA) was conducted to evaluate and compare the effects of available augmentation agents for SRIs in OCD. Method: The data was extracted from 59 relevant clinical trials after a literature search on MEDLINE/PubMed, Scopus, Cochrane databases and clinical trial registries. PRISMA guidelines were followed in data extraction, analysis and reporting. Random effects Bayesian NMA was done to pool the effects across the interventions for the change in Yale‐Brown Obsessive–Compulsive Scale (YBOCS) scoring from baseline to the end of the study. Network graph was built, consistency model was run, node splitting analysis was performed, treatments were ranked as per SUCRA score and meta‐regression was done for refractoriness to SRIs and duration of augmentation therapy as the predictor variables. Results: The drugs showing significant reduction in YBOCS scoring were pregabalin (MD:−8.1;95% CrI: −16, −0.43), memantine (MD:−6.2;95% CrI: −9.9, −2.3), lamotrigine (MD:−6;95% CrI: −12, −0.47), ondansetron (MD:−5.7;95% CrI: −11, −0.67), granisetron (MD:−5.6;95% CrI: −11, −0.44), aripiprazole (MD:−5.4;95% CrI:−9.1, −1.6), risperidone (MD:−3.3;95% CrI: −6.4, −0.20) and topiramate (MD:−5.3;95% CrI: −9.6, −0.97). The node‐split analysis showed that direct and indirect pooled effect sizes for all comparisons were comparable. Meta‐regression showed a statistically non‐significant association between YBOCS score reduction with the duration of augmentation therapy, but significant with SRI‐refractory status. Finally, the results were sorted based on certainty of evidence. Conclusion: Memantine was found to be most effective augmentation agent for SRIs in OCD, followed by lamotrigine, ondansetron and granisetron with moderate certainty of evidence. The augmentation agents showed better symptom reduction in patients with SRI‐refractory OCD in comparison to non‐refractory OCD. PROSPERO registration: CRD42022360110. [ABSTRACT FROM AUTHOR]
Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
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  Data: Pharmacological augmentation of serotonin reuptake inhibitors in patients with obsessive–compulsive disorder: A network meta‐analysis.
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  Data: <searchLink fieldCode="AR" term="%22Maiti%2C+Rituparna%22">Maiti, Rituparna</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mishra%2C+Archana%22">Mishra, Archana</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Srinivasan%2C+Anand%22">Srinivasan, Anand</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mishra%2C+Biswa+Ranjan%22">Mishra, Biswa Ranjan</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Acta+Psychiatrica+Scandinavica%22">Acta Psychiatrica Scandinavica</searchLink>. Jul2023, Vol. 148 Issue 1, p19-31. 13p. 2 Diagrams, 1 Chart, 2 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Serotonin+uptake+inhibitors%22">Serotonin uptake inhibitors</searchLink><br /><searchLink fieldCode="DE" term="%22Obsessive-compulsive+disorder%22">Obsessive-compulsive disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+trial+registries%22">Clinical trial registries</searchLink><br /><searchLink fieldCode="DE" term="%22Independent+variables%22">Independent variables</searchLink><br /><searchLink fieldCode="DE" term="%22Lennox-Gastaut+syndrome%22">Lennox-Gastaut syndrome</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+duration%22">Treatment duration</searchLink><br /><searchLink fieldCode="DE" term="%22Alpha+1-antitrypsin+deficiency%22">Alpha 1-antitrypsin deficiency</searchLink>
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  Label: Abstract
  Group: Ab
  Data: Objectives: The augmentation of serotonin reuptake inhibitors (SRIs) can be achieved by add‐on therapy with different pharmacological agents in obsessive–compulsive disorder (OCD) for a better clinical outcome. This network meta‐analysis (NMA) was conducted to evaluate and compare the effects of available augmentation agents for SRIs in OCD. Method: The data was extracted from 59 relevant clinical trials after a literature search on MEDLINE/PubMed, Scopus, Cochrane databases and clinical trial registries. PRISMA guidelines were followed in data extraction, analysis and reporting. Random effects Bayesian NMA was done to pool the effects across the interventions for the change in Yale‐Brown Obsessive–Compulsive Scale (YBOCS) scoring from baseline to the end of the study. Network graph was built, consistency model was run, node splitting analysis was performed, treatments were ranked as per SUCRA score and meta‐regression was done for refractoriness to SRIs and duration of augmentation therapy as the predictor variables. Results: The drugs showing significant reduction in YBOCS scoring were pregabalin (MD:−8.1;95% CrI: −16, −0.43), memantine (MD:−6.2;95% CrI: −9.9, −2.3), lamotrigine (MD:−6;95% CrI: −12, −0.47), ondansetron (MD:−5.7;95% CrI: −11, −0.67), granisetron (MD:−5.6;95% CrI: −11, −0.44), aripiprazole (MD:−5.4;95% CrI:−9.1, −1.6), risperidone (MD:−3.3;95% CrI: −6.4, −0.20) and topiramate (MD:−5.3;95% CrI: −9.6, −0.97). The node‐split analysis showed that direct and indirect pooled effect sizes for all comparisons were comparable. Meta‐regression showed a statistically non‐significant association between YBOCS score reduction with the duration of augmentation therapy, but significant with SRI‐refractory status. Finally, the results were sorted based on certainty of evidence. Conclusion: Memantine was found to be most effective augmentation agent for SRIs in OCD, followed by lamotrigine, ondansetron and granisetron with moderate certainty of evidence. The augmentation agents showed better symptom reduction in patients with SRI‐refractory OCD in comparison to non‐refractory OCD. PROSPERO registration: CRD42022360110. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/acps.13568
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 13
        StartPage: 19
    Subjects:
      – SubjectFull: Serotonin uptake inhibitors
        Type: general
      – SubjectFull: Obsessive-compulsive disorder
        Type: general
      – SubjectFull: Clinical trial registries
        Type: general
      – SubjectFull: Independent variables
        Type: general
      – SubjectFull: Lennox-Gastaut syndrome
        Type: general
      – SubjectFull: Treatment duration
        Type: general
      – SubjectFull: Alpha 1-antitrypsin deficiency
        Type: general
    Titles:
      – TitleFull: Pharmacological augmentation of serotonin reuptake inhibitors in patients with obsessive–compulsive disorder: A network meta‐analysis.
        Type: main
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            NameFull: Maiti, Rituparna
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            NameFull: Mishra, Archana
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            NameFull: Srinivasan, Anand
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            NameFull: Mishra, Biswa Ranjan
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            – D: 01
              M: 07
              Text: Jul2023
              Type: published
              Y: 2023
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              Value: 148
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