Title:Anti-Androgen Drugs in the Treatment of Obsessive-Compulsive Disorder: A Systematic Review
Volume: 27
Issue: 40
Author(s): Homa Nomani, Amir Hooshang Mohammadpour*, Seyed Mohammad Hassan Moallem, Mahdi Jannati YazdanAbad, George E. Barreto and Amirhossein Sahebkar*
Affiliation:
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad,Iran
- Halal Research Center of IRI, FDA, Tehran,Iran
Keywords:
Obsessive compulsive disorder, luteinizing hormone-releasing hormone, neurosteroid, dehydroepiandrosterone,
N-methyl-D-aspartic acid, Tourette syndrome.
Abstract:
Objective: This study aimed to systematically investigate whether anti-androgens could
significantly reduce Obsessive-Compulsive Disorder (OCD) symptoms compared to placebo or usual
care in OCD patients.
Methods: PubMed, EMBASE, CENTRAL and International Clinical Trials Registry Platform
(ICTRP) databases were searched up to October 2018 using relevant keywords. All randomized and if
not available non-randomized studies conducted on a population including OCD patients who were
administered with anti-androgen, which reported changes in their symptoms, were included. The studies
on compulsive hypersexuality were excluded. Required data were extracted from full-text of the
included articles by two independent authors. One randomized and four non-randomized trials were
found.
Results: The only randomized trial showed that flutamide, an anti-androgen agent, was effective in
reducing compulsion scores in male OCD patients with comorbid Tourette syndrome, compared to
placebo. Three out of four non-randomized trials showed that different anti-androgens including
finasteride, cyproterone acetate and triptorelin were effective in reducing OCD symptoms. The only
study, which failed to show the efficacy of an anti-androgen agent, administered OCD patients with
flutamide. Despite the positive results, available studies provide the evidence with low quality based
on the Grades of Recommendation, Assessment, Development and Evaluation Working Group
(GRADE) approach.
Conclusion: Available studies are not sufficient for a precise answer to our study question. There is
still a need for further large randomized blinded clinical trials to evaluate the effectiveness of antiandrogens
in OCD patients. It is recommended that gender, comorbidities and subscales of Yale-
Brown Obsessive-Compulsive Score (Y-BOCS) should be considered in designing the studies and
interpreting their results.
