A Phase 2/3 interventional study of Troriluzole and Placebo in Obsessive-Compulsive Disorder, sponsored by Biohaven Pharmaceuticals, Inc.. Completed at 57 sites in United States. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-01-22.
Sponsored by Biohaven Pharmaceuticals, Inc. · Phase 2/3, Interventional, and Treatment
The purpose of this study is to evaluate the efficacy of troriluzole as adjunctive therapy versus placebo in participants with obsessive compulsive disorder (OCD) who had an inadequate response to selective serotonin reuptake inhibitor (SSRI), clomipramine, venlafaxine, or desvenlafaxine treatment
Participants must be currently experiencing non-response or inadequate response to their current standard of care (SOC) medication defined as:
Exclusion Criteria:
Participants should be excluded with a history of more than 2 previous failed treatment trials of SSRIs, clomipramine, venlafaxine, or desvenlafaxine (not including the current SSRI trial) given for an adequate duration at an adequate dose as defined by the following criteria taken from the Massachusetts General Hospital Treatment Response Questionnaire for OCD (MGH-TRQ-OCD) as follows:
Drug: Troriluzole
Drug: Placebo
Troriluzole, 140 mg capsules once daily (QD) orally for the first 4 weeks and 200 mg (140 mg+ 60 mg capsules QD) for an additional 8 weeks
Matching capsule once daily (QD)
Change From Baseline in the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Total Score
The Y-BOCS is a clinician-administered scale used extensively in research and clinical practice to both rate severity of obsessive compulsive disorder (OCD) and to monitor improvement during treatment. It is designed to rate the severity of obsessions and compulsions as well as the type of symptoms in patients with OCD. The scale consists of 10 items; the first 5 items assess obsessions, and the last 5 items assess compulsions. Subscale scores can be calculated for obsessions and compulsions, each on a scale of 0 to 20. A total score ranging from 0 to 40 can then be correlated to overall severity. The higher the number on the Y-BOCS, the more severe the symptoms.
Time frame: Baseline, Week 12
Number of Participants With Adverse Events (AEs), Serious AEs (SAEs) and AEs Leading to Study Drug Discontinuation in the DB Randomization Phase
An AE is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in participants or clinical investigation participants administered an investigational (medicinal) product and that does not necessarily have a causal relationship with this treatment. An SAE was defined as any event that met any of the following criteria at any dose: death; life-threatening; inpatient hospitalization or prolongation of existing hospitalization; persistent or significant disability/incapacity; congenital anomaly/birth defect in the offspring of a participant who received study drug; other important medical events that may not have resulted in death, been life-threatening, or required hospitalization, or, based upon appropriate medical judgment, may have jeopardized the participant and may have required medical or surgical intervention to prevent other serious outcomes.
Time frame: Up to 12 weeks
Number of Participants With Adverse Events (AEs), Serious AEs (SAEs) and AEs Leading to Study Drug Discontinuation in the Open-Label Extension Phase
An AE is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in participants or clinical investigation participants administered an investigational (medicinal) product and that does not necessarily have a causal relationship with this treatment. An SAE was defined as any event that met any of the following criteria at any dose: death; life-threatening; inpatient hospitalization or prolongation of existing hospitalization; persistent or significant disability/incapacity; congenital anomaly/birth defect in the offspring of a participant who received study drug; other important medical events that may not have resulted in death, been life-threatening, or required hospitalization, or, based upon appropriate medical judgment may, have jeopardized the participant and may have required medical or surgical intervention to prevent other serious outcomes.
Time frame: Up to 192 weeks
Number of Participants With Clinically Significant Laboratory Abnormalities During the DB Randomization Phase
Clinically significant laboratory abnormalities were defined as Grade 3 or 4 laboratory test results according to numeric laboratory test criteria found in Common Technical Criteria for Adverse Events Version 5.0 (2017) if available; otherwise, according to Division of Acquired Immune Deficiency Syndrome Table for Grading the Severity of Adult and Pediatric Adverse Events Corrected Version 2.1 (2017). Laboratory tests of clinical interest for troriluzole included absolute neutrophil count \< 500 per mm\^3, alanine aminotransferase or aspartate aminotransferase \> 3x upper limit of normal (ULN), and total bilirubin ≥ 2x ULN (Laboratory results were presented in US units).
Time frame: Up to 12 weeks
Change From Baseline in Functional Disability Assessed Using the Sheehan Disability Scale (SDS) Total Score
The SDS was assessed in 3 domains: work/school (0-10), social life (0-10), and family life (0-10). The score from each domain was summed into a single dimensional measure of global functional impairment that ranges from 0 (unimpaired) to 30 (highly impaired). If the participant has not worked or studied for reasons unrelated to OCD, then the total score was considered as missing.
Time frame: Baseline, Week 12
Change From Baseline in Clinical Global Impression of Severity Scale (CGI-S) Score
Measures severity of illness at the time of assessment compared with start of treatment. Scores range from 1 (normal, not at all ill) to 7 (among the most extremely ill patients).
Time frame: Baseline, Week 12
Change From Baseline in the Y-BOCS Obsessions Sub-Scale Score
The Y-BOCS Obsessions Sub-scale consists of the last 5 items on the Y-BOCS and is measured on a scale of 0 to 20. A higher score on the Y-BOCS corresponds to greater symptom severity.
Time frame: Baseline, Week 12
Change From Baseline in the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Total Score at Weeks 4 and 8
The Y-BOCS is a clinician-administered scale used extensively in research and clinical practice to both rate severity of obsessive compulsive disorder (OCD) and to monitor improvement during treatment. It is designed to rate the severity of obsessions and compulsions as well as the type of symptoms in patients with OCD. The scale consists of 10 items; the first 5 items assess obsessions, and the last 5 items assess compulsions. Subscale scores can be calculated for obsessions and compulsions, each on a scale of 0 to 20. A total score ranging from 0 to 40 can then be correlated to overall severity. The higher the number on the Y-BOCS, the more severe the symptoms.
Time frame: Baseline, Week 4 and Week 8
The study was conducted at 56 sites in the United States.
| Milestone | Troriluzole - Randomization Phase | Placebo - Randomization Phase |
|---|---|---|
| Started | 124 | 124 |
| Treated | 122 | 122 |
| Modified intent-to- treat (mitt) participants | 115 | 117 |
| Completed | 101 | 109 |
| Not completed | 23 | 15 |
| Withdrew: Adverse event | 9 | 4 |
| Withdrew: Withdrawal by subject | 6 | 5 |
| Withdrew: Physician decision | 1 | 1 |
| Withdrew: Sponsor decision | 3 | 0 |
| Withdrew: Lost to follow-up | 2 | 4 |
| Withdrew: Randomization error | 0 | 1 |
| Withdrew: Subject unable to return due to covid | 1 | 0 |
| Withdrew: Unable to complete week 12 visit at site | 1 | 0 |
The Y-BOCS is a clinician-administered scale used extensively in research and clinical practice to both rate severity of obsessive compulsive disorder (OCD) and to monitor improvement during treatment. It is designed to rate the severity of obsessions and compulsions as well as the type of symptoms in patients with OCD. The scale consists of 10 items; the first 5 items assess obsessions, and the last 5 items assess compulsions. Subscale scores can be calculated for obsessions and compulsions, each on a scale of 0 to 20. A total score ranging from 0 to 40 can then be correlated to overall severity. The higher the number on the Y-BOCS, the more severe the symptoms.
| Scores on a scale | Troriluzole - Randomization Phase | Placebo - Randomization Phase |
|---|---|---|
| Change From Baseline in the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Total Score | -5.91 (-7.05 to -4.77) | -4.91 (-6.03 to -3.79) |
An AE is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in participants or clinical investigation participants administered an investigational (medicinal) product and that does not necessarily have a causal relationship with this treatment. An SAE was defined as any event that met any of the following criteria at any dose: death; life-threatening; inpatient hospitalization or prolongation of existing hospitalization; persistent or significant disability/incapacity; congenital anomaly/birth defect in the offspring of a participant who received study drug; other important medical events that may not have resulted in death, been life-threatening, or required hospitalization, or, based upon appropriate medical judgment, may have jeopardized the participant and may have required medical or surgical intervention to prevent other serious outcomes.
| participants | Troriluzole - Randomization Phase | Placebo - Randomization Phase |
|---|---|---|
| Participants with at least 1 AE | 61 | 61 |
| Participants with at least 1 SAE | 0 | 0 |
| Participants with at least 1 AEs Leading to Study Drug Discontinuation | 13 | 5 |
An AE is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in participants or clinical investigation participants administered an investigational (medicinal) product and that does not necessarily have a causal relationship with this treatment. An SAE was defined as any event that met any of the following criteria at any dose: death; life-threatening; inpatient hospitalization or prolongation of existing hospitalization; persistent or significant disability/incapacity; congenital anomaly/birth defect in the offspring of a participant who received study drug; other important medical events that may not have resulted in death, been life-threatening, or required hospitalization, or, based upon appropriate medical judgment may, have jeopardized the participant and may have required medical or surgical intervention to prevent other serious outcomes.
Results for this outcome have not been posted.
Clinically significant laboratory abnormalities were defined as Grade 3 or 4 laboratory test results according to numeric laboratory test criteria found in Common Technical Criteria for Adverse Events Version 5.0 (2017) if available; otherwise, according to Division of Acquired Immune Deficiency Syndrome Table for Grading the Severity of Adult and Pediatric Adverse Events Corrected Version 2.1 (2017). Laboratory tests of clinical interest for troriluzole included absolute neutrophil count \< 500 per mm\^3, alanine aminotransferase or aspartate aminotransferase \> 3x upper limit of normal (ULN), and total bilirubin ≥ 2x ULN (Laboratory results were presented in US units).
| participants | Troriluzole - Randomization Phase | Placebo - Randomization Phase |
|---|---|---|
| Hemoglobin, serum | 0 | 0 |
| Lymphocytes, low | 0 | 0 |
| Lymphocytes, high | 0 | 0 |
| Neutrophils | 0 | 1 |
| Platelets | 0 | 0 |
| White blood cells | 0 | 0 |
| Alanine Aminotransferase | 0 | 0 |
| Albumin | 0 | 0 |
| Alkaline Phosphatase | 0 | 0 |
| Aspartate Aminotransferase | 2 | 0 |
| Bicarbonate | 0 | 0 |
| Bilirubin | 0 | 0 |
| Calcium, low | 0 | 0 |
| Calcium, high | 0 | 0 |
| Creatine Kinase | 6 | 2 |
| Creatinine | 0 | 0 |
| Glucose, Serum, low | 0 | 1 |
| Glucose, Serum, high | 0 | 0 |
| Lactate Dehydrogenase | 0 | 0 |
| Potassium, low | 0 | 0 |
| Potassium, high | 1 | 0 |
| Sodium, low | 0 | 1 |
| Sodium, high | 0 | 0 |
| Urate | 0 | 0 |
| Glucose, Urine | 1 | 1 |
| Protein, Urine | 0 | 0 |
The SDS was assessed in 3 domains: work/school (0-10), social life (0-10), and family life (0-10). The score from each domain was summed into a single dimensional measure of global functional impairment that ranges from 0 (unimpaired) to 30 (highly impaired). If the participant has not worked or studied for reasons unrelated to OCD, then the total score was considered as missing.
| Scores on a scale | Troriluzole - Randomization Phase | Placebo - Randomization Phase |
|---|---|---|
| Change From Baseline in Functional Disability Assessed Using the Sheehan Disability Scale (SDS) Total Score | -4.68 (-6.01 to -3.36) | -3.68 (-4.96 to -2.39) |
Measures severity of illness at the time of assessment compared with start of treatment. Scores range from 1 (normal, not at all ill) to 7 (among the most extremely ill patients).
| Scores on a scale | Troriluzole - Randomization Phase | Placebo - Randomization Phase |
|---|---|---|
| Change From Baseline in Clinical Global Impression of Severity Scale (CGI-S) Score | -0.67 (-0.84 to -0.50) | -0.59 (-0.76 to -0.42) |
The Y-BOCS Obsessions Sub-scale consists of the last 5 items on the Y-BOCS and is measured on a scale of 0 to 20. A higher score on the Y-BOCS corresponds to greater symptom severity.
| Scores on a scale | Troriluzole - Randomization Phase | Placebo - Randomization Phase |
|---|---|---|
| Change From Baseline in the Y-BOCS Obsessions Sub-Scale Score | -2.91 (-3.53 to -2.28) | -2.55 (-3.16 to -1.93) |
The Y-BOCS is a clinician-administered scale used extensively in research and clinical practice to both rate severity of obsessive compulsive disorder (OCD) and to monitor improvement during treatment. It is designed to rate the severity of obsessions and compulsions as well as the type of symptoms in patients with OCD. The scale consists of 10 items; the first 5 items assess obsessions, and the last 5 items assess compulsions. Subscale scores can be calculated for obsessions and compulsions, each on a scale of 0 to 20. A total score ranging from 0 to 40 can then be correlated to overall severity. The higher the number on the Y-BOCS, the more severe the symptoms.
| Scores on a scale | Troriluzole - Randomization Phase | Placebo - Randomization Phase |
|---|---|---|
| Week 4 | -3.40 (-4.26 to -2.53) | -2.93 (-3.78 to -2.08) |
| Week 8 | -5.10 (-6.16 to -4.04) | -3.56 (-4.59 to -2.53) |
Collected over Randomization Phase: Maximum duration: 12 weeks. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Troriluzole - Randomization Phase | 0/122 (0%) | 0/122 (0%) | 35/122 (28.7%) |
| Placebo - Randomization Phase | 0/122 (0%) | 0/122 (0%) | 24/122 (19.7%) |
| Event | Troriluzole - Randomization Phase | Placebo - Randomization Phase |
|---|---|---|
| HeadacheNervous system disorders | 10/122 | 8/122 |
| DizzinessNervous system disorders | 9/122 | 2/122 |
| DiarrhoeaGastrointestinal disorders | 1/122 | 9/122 |
| FatigueGeneral disorders | 9/122 | 5/122 |
| SomnolenceNervous system disorders | 8/122 | 2/122 |
| NauseaGastrointestinal disorders | 8/122 | 2/122 |
| NasopharyngitisInfections and infestations | 7/122 | 1/122 |
Treated participants in the randomization phase: Enrolled participants who received at least 1 dose of blinded study therapy (troriluzole or placebo).
| Age, Continuous(Years) | Troriluzole - Randomization Phase | Placebo - Randomization Phase | Total |
|---|---|---|---|
| Mean | 37.9 ± 13.09 | 35.5 ± 13.26 | 36.7 ± 13.20 |
| Sex: Female, Male(Participants) | Troriluzole - Randomization Phase | Placebo - Randomization Phase | Total |
|---|---|---|---|
| Female | 75 | 74 | 149 |
| Male | 47 | 48 | 95 |
| Ethnicity (NIH/OMB)(Participants) | Troriluzole - Randomization Phase | Placebo - Randomization Phase | Total |
|---|---|---|---|
| Hispanic or Latino | 10 | 17 | 27 |
| Not Hispanic or Latino | 112 | 105 | 217 |
| Unknown or Not Reported | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | Troriluzole - Randomization Phase | Placebo - Randomization Phase | Total |
|---|---|---|---|
| American Indian or Alaska Native | 1 | 2 | 3 |
| Asian | 8 | 7 | 15 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 12 | 7 | 19 |
| White | 100 | 103 | 203 |
| More than one race | 1 | 3 | 4 |
| Unknown or Not Reported | 0 | 0 | 0 |
| Total Y-BOCS score at Randomization(Units on a scale) | Troriluzole - Randomization Phase | Placebo - Randomization Phase | Total |
|---|---|---|---|
| Mean | 25.9 ± 3.91 | 26.0 ± 4.32 | 26.0 ± 4.11 |
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Obsessive-Compulsive Disorder→
Biohaven Pharmaceuticals, Inc.