{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:11:19Z","timestamp":1783905079658,"version":"3.55.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,11]]},"DOI":"10.7759\/cureus.112492","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:39:24Z","timestamp":1783903164000},"source":"Crossref","is-referenced-by-count":0,"title":["Differential Improvement in Obsessive Rumination and Fantasy Intrusions Versus Attachment-Related Emotional Dysregulation During Oral Glutamatergic Augmentation in a 16-Year-Old Adolescent"],"prefix":"10.7759","author":[{"given":"Hoi Ki","family":"Cheung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngo","family":"Cheung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2011.09.019","article-title":"Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder","volume":"51","author":"Geller DA","year":"2012","unstructured":"Geller DA, March J. Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry. 2012, 51:98-113. 10.1016\/j.jaac.2011.09.019","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"ref2","article-title":"Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial","volume":"292","year":"2004","unstructured":"Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder. the Pediatric OCD Treatment Study (POTS) randomized controlled trial. JAMA. 2004, 292:1969-76.","journal-title":"JAMA"},{"key":"ref3","doi-asserted-by":"crossref","DOI":"10.1016\/j.biopsych.2012.05.028","article-title":"Effects of ketamine in treatment-refractory obsessive-compulsive disorder","volume":"72","author":"Bloch MH","year":"2012","unstructured":"Bloch MH, Wasylink S, Landeros-Weisenberger A, et al.. Effects of ketamine in treatment-refractory obsessive-compulsive disorder. Biol Psychiatry. 2012, 72:964-70.","journal-title":"Biol Psychiatry"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2011.09.006","article-title":"Glutamate abnormalities in obsessive compulsive disorder: neurobiology, pathophysiology, and treatment","volume":"132","author":"Pittenger C","year":"2011","unstructured":"Pittenger C, Bloch MH, Williams K. Glutamate abnormalities in obsessive compulsive disorder: neurobiology, pathophysiology, and treatment. Pharmacol Ther. 2011, 132:314-32. 10.1016\/j.pharmthera.2011.09.006","journal-title":"Pharmacol Ther"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2013.150","article-title":"Randomized controlled crossover trial of ketamine in obsessive-compulsive disorder: proof-of-concept","volume":"38","author":"Rodriguez CI","year":"2013","unstructured":"Rodriguez CI, Kegeles LS, Levinson A, et al.. Randomized controlled crossover trial of ketamine in obsessive-compulsive disorder: proof-of-concept. Neuropsychopharmacology. 2013, 38:2475-83. 10.1038\/npp.2013.150","journal-title":"Neuropsychopharmacology"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1126\/science.1222939","article-title":"Synaptic dysfunction in depression: potential therapeutic targets","volume":"338","author":"Duman RS","year":"2012","unstructured":"Duman RS, Aghajanian GK. Synaptic dysfunction in depression: potential therapeutic targets. Science. 2012, 338:68-72. 10.1126\/science.1222939","journal-title":"Science"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1126\/science.1190287","article-title":"mTOR-dependent synapse formation underlies the rapid antidepressant effects of NMDA antagonists","volume":"329","author":"Li N","year":"2010","unstructured":"Li N, Lee B, Liu RJ, et al.. mTOR-dependent synapse formation underlies the rapid antidepressant effects of NMDA antagonists. Science. 2010, 329:959-64. 10.1126\/science.1190287","journal-title":"Science"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2007.05.028","article-title":"Cellular mechanisms underlying the antidepressant effects of ketamine: role of \u03b1-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors","volume":"63","author":"Maeng S","year":"2008","unstructured":"Maeng S, Zarate Jr CA, Du J, Schloesser RJ, McCammon J, Chen G, Manji HK. Cellular mechanisms underlying the antidepressant effects of ketamine: role of \u03b1-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors. Biol Psychiatry. 2008, 63:349-52. 10.1016\/j.biopsych.2007.05.028","journal-title":"Biol Psychiatry"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/nature17998","article-title":"NMDAR inhibition-independent antidepressant actions of ketamine metabolites","volume":"533","author":"Zanos P","year":"2016","unstructured":"Zanos P, Moaddel R, Morris PJ, et al.. NMDAR inhibition-independent antidepressant actions of ketamine metabolites. Nature. 2016, 533:481-6. 10.1038\/nature17998","journal-title":"Nature"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2026.1751605","article-title":"DXM, CYP2D6-inhibiting antidepressants, piracetam, and glutamine: proposing a ketamine-class antidepressant regimen with existing drugs","volume":"17","author":"Cheung N","year":"2026","unstructured":"Cheung N. DXM, CYP2D6-inhibiting antidepressants, piracetam, and glutamine: proposing a ketamine-class antidepressant regimen with existing drugs. Front Psychiatry. 2026, 17:10.3389\/fpsyt.2026.1751605","journal-title":"Front Psychiatry"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1021\/jm901905j","article-title":"Piracetam defines a new binding site for allosteric modulators of \u03b1-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors","volume":"53","author":"Ahmed AH","year":"2010","unstructured":"Ahmed AH, Oswald RE. Piracetam defines a new binding site for allosteric modulators of \u03b1-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors. J Med Chem. 2010, 53:2197-203. 10.1021\/jm901905j","journal-title":"J Med Chem"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.104031","article-title":"Glutamatergic enhancement using as-needed dextromethorphan and piracetam in a stimulant-partially responsive adult with ADHD: a single-case report","volume":"18","author":"Cheung N","year":"2026","unstructured":"Cheung N. Glutamatergic enhancement using as-needed dextromethorphan and piracetam in a stimulant-partially responsive adult with ADHD: a single-case report. Cureus. 2026, 18:10.7759\/cureus.104031","journal-title":"Cureus"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1527-3458.2005.tb00268.x","article-title":"Piracetam: a review of pharmacological properties and clinical uses","volume":"11","author":"Winblad B","year":"2005","unstructured":"Winblad B. Piracetam: a review of pharmacological properties and clinical uses. CNS Drug Rev. 2005, 11:169-82. 10.1111\/j.1527-3458.2005.tb00268.x","journal-title":"CNS Drug Rev"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1038\/s41583-021-00507-y","article-title":"Mechanisms governing activity-dependent synaptic pruning in the developing mammalian CNS","volume":"22","author":"Faust TE","year":"2021","unstructured":"Faust TE, Gunner G, Schafer DP. Mechanisms governing activity-dependent synaptic pruning in the developing mammalian CNS. Nat Rev Neurosci. 2021, 22:657-73. 10.1038\/s41583-021-00507-y","journal-title":"Nat Rev Neurosci"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2012.05.006","article-title":"Adolescent neurodevelopment","volume":"52","author":"Spear LP","year":"2013","unstructured":"Spear LP. Adolescent neurodevelopment. J Adolesc Health. 2013, 52:7-13. 10.1016\/j.jadohealth.2012.05.006","journal-title":"J Adolesc Health"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.20944\/preprints202512.0074.v1","article-title":"Timing is everything: why the Cheung glutamatergic regimen is contraindicated in young children with autism but promising after puberty","author":"Cheung N","year":"2025","unstructured":"Cheung N. Timing is everything: why the Cheung glutamatergic regimen is contraindicated in young children with autism but promising after puberty. Preprints. 2025, 10.20944\/preprints202512.0074.v1","journal-title":"Preprints"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.107120","article-title":"A developmental taxonomy of autism and the precision timing of the Cheung glutamatergic regimen","volume":"18","author":"Cheung N","year":"2026","unstructured":"Cheung N. A developmental taxonomy of autism and the precision timing of the Cheung glutamatergic regimen. Cureus. 2026, 18:10.7759\/cureus.107120","journal-title":"Cureus"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2014.07.040","article-title":"Loss of mTOR-dependent macroautophagy causes autistic-like synaptic pruning deficits","volume":"83","author":"Tang G","year":"2014","unstructured":"Tang G, Gudsnuk K, Kuo SH, et al.. Loss of mTOR-dependent macroautophagy causes autistic-like synaptic pruning deficits. Neuron. 2014, 83:1131-43. 10.1016\/j.neuron.2014.07.040","journal-title":"Neuron"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.20944\/preprints202511.2246.v1","article-title":"Clinical experience and optimisation of the Cheung glutamatergic regimen for refractory psychiatric diseases","author":"Cheung N","year":"2025","unstructured":"Cheung N. Clinical experience and optimisation of the Cheung glutamatergic regimen for refractory psychiatric diseases. Preprints. 2025, 10.20944\/preprints202511.2246.v1","journal-title":"Preprints"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.20944\/preprints202512.0585.v1","article-title":"Dosing schedules for dextromethorphan and piracetam in OCD: a case series on diurnal symptom patterns and split-dosing strategies","author":"Cheung N","year":"2025","unstructured":"Cheung N. Dosing schedules for dextromethorphan and piracetam in OCD: a case series on diurnal symptom patterns and split-dosing strategies. Preprints. 2025, 10.20944\/preprints202512.0585.v1","journal-title":"Preprints"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1038\/sj.mp.4001823","article-title":"A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder","volume":"11","author":"Bloch MH","year":"2006","unstructured":"Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry. 2006, 11:622-32. 10.1038\/sj.mp.4001823","journal-title":"Mol Psychiatry"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.57.8.794","article-title":"A double-blind, placebo-controlled study of risperidone addition in serotonin reuptake inhibitor-refractory obsessive-compulsive disorder","volume":"57","author":"McDougle CJ","year":"2000","unstructured":"McDougle CJ, Epperson CN, Pelton GH, Wasylink S, Price LH. A double-blind, placebo-controlled study of risperidone addition in serotonin reuptake inhibitor-refractory obsessive-compulsive disorder. Arch Gen Psychiatry. 2000, 57:794-801. 10.1001\/archpsyc.57.8.794","journal-title":"Arch Gen Psychiatry"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-014-0317-5","article-title":"Atypical antipsychotic augmentation in SSRI treatment refractory obsessive-compulsive disorder: a systematic review and meta-analysis","volume":"14","author":"Veale D","year":"2014","unstructured":"Veale D, Miles S, Smallcombe N, Ghezai H, Goldacre B, Hodsoll J. Atypical antipsychotic augmentation in SSRI treatment refractory obsessive-compulsive disorder: a systematic review and meta-analysis. BMC Psychiatry. 2014, 14:10.1186\/s12888-014-0317-5","journal-title":"BMC Psychiatry"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.2903","article-title":"Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A genotypes and serotonin reuptake inhibitor antidepressants","volume":"114","author":"Bousman CA","year":"2023","unstructured":"Bousman CA, Stevenson JM, Ramsey LB, et al.. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A genotypes and serotonin reuptake inhibitor antidepressants. Clin Pharmacol Ther. 2023, 114:51-68. 10.1002\/cpt.2903","journal-title":"Clin Pharmacol Ther"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041867","article-title":"The serotonin syndrome","volume":"352","author":"Boyer EW","year":"2005","unstructured":"Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005, 352:1112-20. 10.1056\/NEJMra041867","journal-title":"N Engl J Med"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1097\/00131746-200701000-00002","article-title":"The potential for clinically significant drug-drug interactions involving the CYP2D6 system: effects with fluoxetine and paroxetine versus sertraline","volume":"13","author":"Preskorn SH","year":"2007","unstructured":"Preskorn SH, Shah R, Neff M, Golbeck AL, Choi J. The potential for clinically significant drug-drug interactions involving the CYP2D6 system: effects with fluoxetine and paroxetine versus sertraline. J Psychiatr Pract. 2007, 13:5-12. 10.1097\/00131746-200701000-00002","journal-title":"J Psychiatr Pract"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/S0149-2918(08)80047-1","article-title":"Clinically relevant pharmacokinetic drug interactions with second-generation antidepressants: an update","volume":"30","author":"Spina E","year":"2008","unstructured":"Spina E, Santoro V, D\u2019Arrigo C. Clinically relevant pharmacokinetic drug interactions with second-generation antidepressants: an update. Clin Ther. 2008, 30:1206-27. 10.1016\/S0149-2918(08)80047-1","journal-title":"Clin Ther"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1549","article-title":"Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents","volume":"302","author":"Correll CU","year":"2009","unstructured":"Correll CU, Manu P, Olshanskiy V, Napolitano B, Kane JM, Malhotra AK. Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents. JAMA. 2009, 302:1765-73. 10.1001\/jama.2009.1549","journal-title":"JAMA"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/16.9.581","article-title":"Evidence-based recommendations for monitoring safety of second-generation antipsychotics in children and youth","volume":"16","author":"Pringsheim T","year":"2011","unstructured":"Pringsheim T, Panagiotopoulos C, Davidson J, Ho J. Evidence-based recommendations for monitoring safety of second-generation antipsychotics in children and youth. Paediatr Child Health. 2011, 16:581-9. 10.1093\/pch\/16.9.581","journal-title":"Paediatr Child Health"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke K","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001, 16:606-13. 10.1046\/j.1525-1497.2001.016009606.x","journal-title":"J Gen Intern Med"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer RL","year":"2006","unstructured":"Spitzer RL, Kroenke K, Williams JB, L\u00f6we B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006, 166:1092-7. 10.1001\/archinte.166.10.1092","journal-title":"Arch Intern Med"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1989.01810110048007","article-title":"The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability","volume":"46","author":"Goodman WK","year":"1989","unstructured":"Goodman WK, Price LH, Rasmussen SA, et al.. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989, 46:1006-11. 10.1001\/archpsyc.1989.01810110048007","journal-title":"Arch Gen Psychiatry"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199706000-00023","article-title":"Children's Yale-Brown Obsessive Compulsive Scale: reliability and validity","volume":"36","author":"Scahill L","year":"1997","unstructured":"Scahill L, Riddle MA, McSwiggin-Hardin M, et al.. Children's Yale-Brown Obsessive Compulsive Scale: reliability and validity. J Am Acad Child Adolesc Psychiatry. 1997, 36:844-52. 10.1097\/00004583-199706000-00023","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1344","article-title":"Cognitive behavior therapy augmentation of pharmacotherapy in pediatric obsessive-compulsive disorder: the Pediatric OCD Treatment Study II (POTS II) randomized controlled trial","volume":"306","author":"Franklin ME","year":"2011","unstructured":"Franklin ME, Sapyta J, Freeman JB, et al.. Cognitive behavior therapy augmentation of pharmacotherapy in pediatric obsessive-compulsive disorder: the Pediatric OCD Treatment Study II (POTS II) randomized controlled trial. JAMA. 2011, 306:1224-32. 10.1001\/jama.2011.1344","journal-title":"JAMA"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e318272677d","article-title":"N-acetylcysteine add-on treatment in refractory obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled trial","volume":"32","author":"Afshar H","year":"2012","unstructured":"Afshar H, Roohafza H, Mohammad-Beigi H, et al.. N-acetylcysteine add-on treatment in refractory obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled trial. J Clin Psychopharmacol. 2012, 32:797-803. 10.1097\/JCP.0b013e318272677d","journal-title":"J Clin Psychopharmacol"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.9758\/cpn.2015.13.1.12","article-title":"N-acetyl cysteine in the treatment of obsessive compulsive and related disorders: a systematic review","volume":"13","author":"Oliver G","year":"2015","unstructured":"Oliver G, Dean O, Camfield D, Blair-West S, Ng C, Berk M, Sarris J. N-acetyl cysteine in the treatment of obsessive compulsive and related disorders: a systematic review. Clin Psychopharmacol Neurosci. 2015, 13:12-24. 10.9758\/cpn.2015.13.1.12","journal-title":"Clin Psychopharmacol Neurosci"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/510428-differential-improvement-in-obsessive-rumination-and-fantasy-intrusions-versus-attachment-related-emotional-dysregulation-during-oral-glutamatergic-augmentation-in-a-16-year-old-adolescent","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:39:25Z","timestamp":1783903165000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/510428-differential-improvement-in-obsessive-rumination-and-fantasy-intrusions-versus-attachment-related-emotional-dysregulation-during-oral-glutamatergic-augmentation-in-a-16-year-old-adolescent"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,11]]},"references-count":36,"URL":"https:\/\/doi.org\/10.7759\/cureus.112492","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,11]]}}}