Table of Contents Author Guidelines Submit a Manuscript
Neural Plasticity
Volume 2009 (2009), Article ID 768398, 25 pages
http://dx.doi.org/10.1155/2009/768398
Research Article

High-Dose Glycine Treatment of Refractory Obsessive-Compulsive Disorder and Body Dysmorphic Disorder in a 5-Year Period

1Department of Medicine, St. Luke's-Roosevelt Hospital Center, Columbia University, New York, NY 10019, USA
2Department of Radiology, New York-Presbyterian Hospital, Columbia-Presbyterian Medical Center, New York, NY 10032, USA
3Department of Pediatrics, New York-Presbyterian Hospital, Columbia-Presbyterian Medical Center, New York, NY 10032, USA

Received 15 May 2009; Revised 12 August 2009; Accepted 4 December 2009

Academic Editor: Zygmunt Galdzicki

Copyright © 2009 W. Louis Cleveland et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This paper describes an individual who was diagnosed with obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD) at age 17 when education was discontinued. By age 19, he was housebound without social contacts except for parents. Adequate trials of three selective serotonin reuptake inhibitors, two with atypical neuroleptics, were ineffective. Major exacerbations following ear infections involving Group A 𝛽 -hemolytic streptococcus at ages 19 and 20 led to intravenous immune globulin therapy, which was also ineffective. At age 22, another severe exacerbation followed antibiotic treatment for H. pylori. This led to a hypothesis that postulates deficient signal transduction by the N-methyl-D-aspartate receptor (NMDAR). Treatment with glycine, an NMDAR coagonist, over 5 years led to robust reduction of OCD/BDD signs and symptoms except for partial relapses during treatment cessation. Education and social life were resumed and evidence suggests improved cognition. Our findings motivate further study of glycine treatment of OCD and BDD.