Amantadine as an Adjunct Therapy for Moderate to Severe OCD

Dr. Danish and Philadelphia Integrative Psychiatry endorse the use of adjunctive Amantadine for some individuals with OCD. This blog will look at some of the research which support Amantadine, as well as dosing, and potential side effects. 

Amantadine has shown benefits for other mental health disorders, including anxiety, impulsivity, focus, and irritability. For more on amantadine and focus, please read our blog here.  

Efficacy

The study published in Psychiatry and Clinical Neurosciences involved 100 patients diagnosed with moderate to severe OCD. These patients were divided into two groups: one received fluvoxamine (100 mg twice a day) plus a placebo, and the other received fluvoxamine (100 mg twice a day) plus Amantadine (100 mg daily) for 12 weeks. The results showed significant improvements in OCD symptoms, with Y-BOCS total scores decreasing from 30.03 ± 3.93 to 17.62 ± 4.01 in the Amantadine group, compared to a reduction from 29.63 ± 1.70 to 19.93 ± 7.11 in the placebo group (P = 0.047). Additionally, the obsession subscale scores were significantly reduced in the Amantadine group, suggesting its effectiveness in managing OCD symptoms.

Another 2014 study, evaluated the effectiveness of Amantadine as an adjunctive therapy to SSRIs in eight OCD patients unresponsive to SSRIs alone. The open-label study demonstrated significant reductions in total Y-BOCS scores from 28 ± 4.5 to 18.8 ± 8.8 (P < 0.01), in the compulsion sub-scale from 15.3 ± 3.2 to 10.6 ± 4.7 (P < 0.02), and in the obsession sub-scale from 12.7 ± 3.3 to 8.1 ± 5 (P < 0.05). Anxiety and depression levels remained unchanged, indicating that Amantadine effectively reduces OCD symptoms through NMDA receptor modulation, warranting further large-scale studies.

Dosing

Patients under 13 years old:

• Start with 25 mg of liquid Amantadine each morning.

• Increase by 25 mg every 7 days.

• Goal dose: 75 to 100 mg daily, with some patients eventually taking the dose twice per day.

Patients aged 13-15 years old:

• Start with 50 mg daily.

• Increase by 25 mg every 5 days until reaching 100 mg daily.

• If well tolerated, add another 100 mg dose at 4 PM.

Patients aged 16 and older:

• Start with 100 mg daily.

• Consider increasing to twice per day if needed.

Side Effects

Amantadine is generally well-tolerated, but patients may experience some side effects. Common side effects include:

• Decreased appetite

• Insomnia

• Nausea

• Dizziness

• Dry mouth

• Constipation

It is important for patients to report any adverse effects to their healthcare provider. Patients with reduced kidney function or glaucoma should use Amantadine with caution due to potential anticholinergic effects.

Getting in Touch with Dr. Danish and His Team

At Philadelphia Integrative Psychiatry, we continue to stay on top of the latest research related to Amantadine as an adjunctive treatment for OCD so we can provide the best quality care in a safe manner. Our holistic and integrative approach ensures that we consider all aspects of our patients' well-being in developing personalized treatment plans. If you or a loved one are seeking support for OCD or similar conditions, please text or call 610-999-6414 to learn how we can help.

For more on this topic and related subjects, please look at these blogs:

1. Discover how we treat OCD with a comprehensive approach at Philadelphia Integrative Psychiatry.

2. Unveil the power of Cognitive Behavioral Therapy in managing and overcoming OCD.

3. Explore innovative OCD treatments available at Philadelphia Integrative Psychiatry.

4. Many patients with OCD will require SSRIs or SNRIs be dosed at the high end of the dose range, and, in some cases, even higher than what is listed by the manufacturer. 

5. Follow our guide to seeking OCD treatment for a structured path to recovery.

6. Understand inflammation's role in tic disorders and OCD through our latest blog.

7. Learn about the nuances of social and relationship OCD and effective ways to manage it.

8. Consider Pregabalin as an augmentation strategy for treatment-resistant OCD.

9. Discover the benefits of N-acetylcysteine (NAC) as a supplement for OCD.

10. Learn about Inositol for OCD and its potential benefits in our latest post.

11. Understand the application of Memantine in treating OCD symptoms effectively.

References

1. Naderi, S., Faghih, H., Aqamolaei, A., Mortazavi, S. H., Mortezaei, A., Sahebolzamani, E., Rezaei, F., & Akhondzadeh, S. (2018). Amantadine as adjuvant therapy in the treatment of moderate to severe obsessive–compulsive disorder: A double-blind randomized trial with placebo control. Psychiatry and Clinical Neurosciences. Link

2. Stryjer, R., Budnik, D., Ebert, T., Green, T., Polak, L., Weizman, S., & Spivak, B. (2014). Amantadine augmentation therapy for obsessive-compulsive patients resistant to SSRIs: An open-label study. Clinical Neuropharmacology, 37(3), 79-81. Link