OBJECTIVE: Previous studies suggest that the unexplained sudden and severe onset of obsessive-compulsive disorder (OCD) and/or tics may be infection or immune precipitated. Beta lactam antibiotics may be neuroprotective beyond their antimicrobial efficacy. We examine the preliminary safety and efficacy of cefdinir in reducing obsessive-compulsive and/or tic severity in children with new-onset symptoms. METHOD:Twenty subjects were randomized to receive placebo or cefdinir for 30 days for the treatment of recent-onset OCD and/or tics. The placebo group received a comparable inactive treatment matched for taste, color, and consistency. The Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) and Yale Global Tic Severity Scale (YGTSS) were the primary outcome measures utilized. RESULTS: Subjects receiving cefdinir saw notable improvements in tic symptoms, with 44.4% showing at least a 25% reduction in YGTSS (mean decrease=9.5) scores compared with 9.1% of the placebo group (mean decrease=0.13). Despite improvements, significant group differences were not observed for YGTSS (F [1, 13]=4.03, p=0.066) although there were moderate differences between group treatment effects (d=0.72). For OCD symptoms, subjects receiving cefdinir saw improvements in OCD symptoms, with 33.3% showing at least a 25% reduction in CY-BOCS scores (mean decrease=7.8) compared with 27.3% of the placebo group (mean decrease=4.7), but there were also no significant differences for CY-BOCS (F [1, 13]=0.385, p=0.546; d=0.24). CONCLUSIONS: Subjects assigned to cefdinir exhibited notable, albeit nonstatistically significant, improvements in tic symptoms, compared with the placebo group. There were also some improvements in OCD symptoms, although these were not significant. Overall, cefdinir was well tolerated. Given these preliminary results, a fully powered study is warranted to explore the efficacy of cefdinir as a therapeutic tool for new-onset pediatric neuropsychiatric symptoms, particularly those that appear to be precipitated by infection.
RCT Entities:
OBJECTIVE: Previous studies suggest that the unexplained sudden and severe onset of obsessive-compulsive disorder (OCD) and/or tics may be infection or immune precipitated. Beta lactam antibiotics may be neuroprotective beyond their antimicrobial efficacy. We examine the preliminary safety and efficacy of cefdinir in reducing obsessive-compulsive and/or tic severity in children with new-onset symptoms. METHOD: Twenty subjects were randomized to receive placebo or cefdinir for 30 days for the treatment of recent-onset OCD and/or tics. The placebo group received a comparable inactive treatment matched for taste, color, and consistency. The Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) and Yale Global Tic Severity Scale (YGTSS) were the primary outcome measures utilized. RESULTS: Subjects receiving cefdinir saw notable improvements in tic symptoms, with 44.4% showing at least a 25% reduction in YGTSS (mean decrease=9.5) scores compared with 9.1% of the placebo group (mean decrease=0.13). Despite improvements, significant group differences were not observed for YGTSS (F [1, 13]=4.03, p=0.066) although there were moderate differences between group treatment effects (d=0.72). For OCD symptoms, subjects receiving cefdinir saw improvements in OCD symptoms, with 33.3% showing at least a 25% reduction in CY-BOCS scores (mean decrease=7.8) compared with 27.3% of the placebo group (mean decrease=4.7), but there were also no significant differences for CY-BOCS (F [1, 13]=0.385, p=0.546; d=0.24). CONCLUSIONS: Subjects assigned to cefdinir exhibited notable, albeit nonstatistically significant, improvements in tic symptoms, compared with the placebo group. There were also some improvements in OCD symptoms, although these were not significant. Overall, cefdinir was well tolerated. Given these preliminary results, a fully powered study is warranted to explore the efficacy of cefdinir as a therapeutic tool for new-onset pediatric neuropsychiatric symptoms, particularly those that appear to be precipitated by infection.
Authors: S E Swedo; J L Rapoport; D L Cheslow; H L Leonard; E M Ayoub; D M Hosier; E R Wald Journal: Am J Psychiatry Date: 1989-02 Impact factor: 18.112
Authors: Jeffrey D Rothstein; Sarjubhai Patel; Melissa R Regan; Christine Haenggeli; Yanhua H Huang; Dwight E Bergles; Lin Jin; Margaret Dykes Hoberg; Svetlana Vidensky; Dorothy S Chung; Shuy Vang Toan; Lucie I Bruijn; Zao-Zhong Su; Pankaj Gupta; Paul B Fisher Journal: Nature Date: 2005-01-06 Impact factor: 49.962
Authors: Pablo R Moya; Jens R Wendland; Liza M Rubenstein; Kiara R Timpano; Gary A Heiman; Jay A Tischfield; Robert A King; Anne M Andrews; Samanda Ramamoorthy; Francis J McMahon; Dennis L Murphy Journal: Mov Disord Date: 2013-04-29 Impact factor: 10.338
Authors: Elisa Ramos-Sevillano; Cinthya Rodríguez-Sosa; Fabio Cafini; Maria-Jose Giménez; Ana Navarro; David Sevillano; Luis Alou; Ernesto García; Lorenzo Aguilar; Jose Yuste Journal: PLoS One Date: 2012-09-05 Impact factor: 3.240
Authors: Joshua M Nadeau; Cary Jordan; Robert R Selles; Monica S Wu; Morgan A King; Priyal D Patel; Camille E Hanks; Elysse B Arnold; Adam B Lewin; Tanya K Murphy; Eric A Storch Journal: J Child Adolesc Psychopharmacol Date: 2015-05 Impact factor: 2.576
Authors: M Elizabeth Latimer; Nathan L'Etoile; Jakob Seidlitz; Susan E Swedo Journal: J Child Adolesc Psychopharmacol Date: 2015-02-06 Impact factor: 2.576
Authors: Megan D Toufexis; Rebecca Hommer; Diana M Gerardi; Paul Grant; Leah Rothschild; Precilla D'Souza; Kyle Williams; James Leckman; Susan E Swedo; Tanya K Murphy Journal: J Child Adolesc Psychopharmacol Date: 2014-10-20 Impact factor: 2.576
Authors: Rukshan A M Rafeek; Catherine M Lobbe; Ethan C Wilkinson; Adam S Hamlin; Nicholas M Andronicos; David J McMillan; Kadaba S Sriprakash; Natkunam Ketheesan Journal: Animal Model Exp Med Date: 2021-04-08