Efficacy and tolerability of riluzole in psychiatric disorders: A systematic review and preliminary meta-analysis

J. N. de Boer; C. Vingerhoets; M. Hirdes; G. M. McAlonan; T. V. Arnelsvoort; J. R. Zinkstok

doi:10.1016/j.psychres.2019.06.020

Efficacy and tolerability of riluzole in psychiatric disorders: A systematic review and preliminary meta-analysis

J. N. de Boer^*, C. Vingerhoets, M. Hirdes, G. M. McAlonan, T. V. Arnelsvoort, J. R. Zinkstok

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

There is a pressing need for better pharmacological treatment strategies for psychiatric disorders as current treatment often results in partial symptom remission and unwanted side effects. A point of entry may be the glutamatergic system since glutamatergic dysregulation contributes to multiple psychiatric disorders. We evaluated the evidence from randomized controlled trials (RCTs) regarding the use of the glutamatergic drug riluzole in mental illnesses; and conducted preliminary meta-analyses of its effectiveness in treating obsessive compulsive disorder (OCD) and depression.

A systematic search was performed using PubMed (Medline), Embase, Cochrane Database of Systematic Reviews and PsycINFO. Meta-analyses were performed using Comprehensive Meta-Analysis software.

Twenty-three RCTs were included for qualitative analysis and showed positive effects of adjunctive/monotherapy riluzole in patients with OCD, depression, autism, substance abuse and schizophrenia. Seven studies were also used for quantitative analysis, which revealed positive but non-significant effects on OCD and depression. Riluzole was generally well tolerated with few serious adverse events.

The studies included in this systematic review were highly heterogeneous and the number of studies was limited per diagnostic condition. Moreover, few studies have examined riluzole as a single treatment. We suggest carrying out further work to provide definitive evidence for the benefit of riluzole in psychiatric illness.

Original language	English
Pages (from-to)	294-302
Number of pages	9
Journal	Psychiatry Research
Volume	278
DOIs	https://doi.org/10.1016/j.psychres.2019.06.020
Publication status	Published - Aug 2019

Keywords

Riluzole
Systematic review
Meta-analysis
Psychiatric disorder
OBSESSIVE-COMPULSIVE SCALE
ADD-ON RILUZOLE
DOUBLE-BLIND
EXCITATORY/INHIBITORY BALANCE
PHARMACOLOGICAL MODULATION
CONTROLLED-TRIAL
GLUTAMATE
AUTISM
DEPRESSION
KETAMINE

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10.1016/j.psychres.2019.06.020

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@article{a4390fb0d8ca4f4895c67cd26ff10e90,

title = "Efficacy and tolerability of riluzole in psychiatric disorders: A systematic review and preliminary meta-analysis",

abstract = "There is a pressing need for better pharmacological treatment strategies for psychiatric disorders as current treatment often results in partial symptom remission and unwanted side effects. A point of entry may be the glutamatergic system since glutamatergic dysregulation contributes to multiple psychiatric disorders. We evaluated the evidence from randomized controlled trials (RCTs) regarding the use of the glutamatergic drug riluzole in mental illnesses; and conducted preliminary meta-analyses of its effectiveness in treating obsessive compulsive disorder (OCD) and depression.A systematic search was performed using PubMed (Medline), Embase, Cochrane Database of Systematic Reviews and PsycINFO. Meta-analyses were performed using Comprehensive Meta-Analysis software.Twenty-three RCTs were included for qualitative analysis and showed positive effects of adjunctive/monotherapy riluzole in patients with OCD, depression, autism, substance abuse and schizophrenia. Seven studies were also used for quantitative analysis, which revealed positive but non-significant effects on OCD and depression. Riluzole was generally well tolerated with few serious adverse events.The studies included in this systematic review were highly heterogeneous and the number of studies was limited per diagnostic condition. Moreover, few studies have examined riluzole as a single treatment. We suggest carrying out further work to provide definitive evidence for the benefit of riluzole in psychiatric illness.",

keywords = "Riluzole, Systematic review, Meta-analysis, Psychiatric disorder, OBSESSIVE-COMPULSIVE SCALE, ADD-ON RILUZOLE, DOUBLE-BLIND, EXCITATORY/INHIBITORY BALANCE, PHARMACOLOGICAL MODULATION, CONTROLLED-TRIAL, GLUTAMATE, AUTISM, DEPRESSION, KETAMINE",

author = "{de Boer}, {J. N.} and C. Vingerhoets and M. Hirdes and McAlonan, {G. M.} and Arnelsvoort, {T. V.} and Zinkstok, {J. R.}",

note = "Funding Information: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. G.M.M. acknowledges support from the National Institute for Health Research (NIHR) (grant no. IS-BRC-1215-20018 ). Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The authors specifically report no relation with any pharmaceutical company that produces riluzole. Funding Information: None. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. G.M.M. acknowledges support from the National Institute for Health Research (NIHR) (grant no. IS-BRC-1215-20018). Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The authors specifically report no relation with any pharmaceutical company that produces riluzole. Publisher Copyright: {\textcopyright} 2019",

year = "2019",

month = aug,

doi = "10.1016/j.psychres.2019.06.020",

language = "English",

volume = "278",

pages = "294--302",

journal = "Psychiatry Research",

issn = "0165-1781",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Efficacy and tolerability of riluzole in psychiatric disorders

T2 - A systematic review and preliminary meta-analysis

AU - de Boer, J. N.

AU - Vingerhoets, C.

AU - Hirdes, M.

AU - McAlonan, G. M.

AU - Arnelsvoort, T. V.

AU - Zinkstok, J. R.

N1 - Funding Information: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. G.M.M. acknowledges support from the National Institute for Health Research (NIHR) (grant no. IS-BRC-1215-20018 ). Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The authors specifically report no relation with any pharmaceutical company that produces riluzole. Funding Information: None. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. G.M.M. acknowledges support from the National Institute for Health Research (NIHR) (grant no. IS-BRC-1215-20018). Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The authors specifically report no relation with any pharmaceutical company that produces riluzole. Publisher Copyright: © 2019

PY - 2019/8

Y1 - 2019/8

N2 - There is a pressing need for better pharmacological treatment strategies for psychiatric disorders as current treatment often results in partial symptom remission and unwanted side effects. A point of entry may be the glutamatergic system since glutamatergic dysregulation contributes to multiple psychiatric disorders. We evaluated the evidence from randomized controlled trials (RCTs) regarding the use of the glutamatergic drug riluzole in mental illnesses; and conducted preliminary meta-analyses of its effectiveness in treating obsessive compulsive disorder (OCD) and depression.A systematic search was performed using PubMed (Medline), Embase, Cochrane Database of Systematic Reviews and PsycINFO. Meta-analyses were performed using Comprehensive Meta-Analysis software.Twenty-three RCTs were included for qualitative analysis and showed positive effects of adjunctive/monotherapy riluzole in patients with OCD, depression, autism, substance abuse and schizophrenia. Seven studies were also used for quantitative analysis, which revealed positive but non-significant effects on OCD and depression. Riluzole was generally well tolerated with few serious adverse events.The studies included in this systematic review were highly heterogeneous and the number of studies was limited per diagnostic condition. Moreover, few studies have examined riluzole as a single treatment. We suggest carrying out further work to provide definitive evidence for the benefit of riluzole in psychiatric illness.

AB - There is a pressing need for better pharmacological treatment strategies for psychiatric disorders as current treatment often results in partial symptom remission and unwanted side effects. A point of entry may be the glutamatergic system since glutamatergic dysregulation contributes to multiple psychiatric disorders. We evaluated the evidence from randomized controlled trials (RCTs) regarding the use of the glutamatergic drug riluzole in mental illnesses; and conducted preliminary meta-analyses of its effectiveness in treating obsessive compulsive disorder (OCD) and depression.A systematic search was performed using PubMed (Medline), Embase, Cochrane Database of Systematic Reviews and PsycINFO. Meta-analyses were performed using Comprehensive Meta-Analysis software.Twenty-three RCTs were included for qualitative analysis and showed positive effects of adjunctive/monotherapy riluzole in patients with OCD, depression, autism, substance abuse and schizophrenia. Seven studies were also used for quantitative analysis, which revealed positive but non-significant effects on OCD and depression. Riluzole was generally well tolerated with few serious adverse events.The studies included in this systematic review were highly heterogeneous and the number of studies was limited per diagnostic condition. Moreover, few studies have examined riluzole as a single treatment. We suggest carrying out further work to provide definitive evidence for the benefit of riluzole in psychiatric illness.

KW - Riluzole

KW - Systematic review

KW - Meta-analysis

KW - Psychiatric disorder

KW - OBSESSIVE-COMPULSIVE SCALE

KW - ADD-ON RILUZOLE

KW - DOUBLE-BLIND

KW - EXCITATORY/INHIBITORY BALANCE

KW - PHARMACOLOGICAL MODULATION

KW - CONTROLLED-TRIAL

KW - GLUTAMATE

KW - AUTISM

KW - DEPRESSION

KW - KETAMINE

U2 - 10.1016/j.psychres.2019.06.020

DO - 10.1016/j.psychres.2019.06.020

M3 - (Systematic) Review article

C2 - 31254879

SN - 0165-1781

VL - 278

SP - 294

EP - 302

JO - Psychiatry Research

JF - Psychiatry Research

ER -

Efficacy and tolerability of riluzole in psychiatric disorders: A systematic review and preliminary meta-analysis

Abstract

Keywords

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