Riluzole Augmentation in Treatment-Refractory Obsessive-Compulsive Disorder: A Pilot Randomized Placebo-Controlled Trial

Objective Obsessive-compulsive disorder (OCD) affects approximately 2.5% of the population and is associated with significant morbidity. Many patients receive little benefit from the best available treatments, and even those who do respond often suffer from significant residual symptoms. Convergent evidence suggests that abnormalities in glutamate homeostasis and neurotransmission may contribute to OCD and that glutamate-modulating medications may be of benefit in patients whose symptoms are refractory to standard interventions. Small open-label trials of augmentation of SSRI pharmacotherapy with the glutamate modulator riluzole have suggested benefit in adults with refractory symptoms. We report a pilot placebo-control trial of riluzole augmentation of ongoing SRI treatment in SRI-refractory patients.