Psychiatr. pro Praxi, 2009; 10(1): 31-35

Pharmacotherapy of obsessive-compulsive disorder

MUDr. Jiřina Kosová
Psychiatrické centrum Praha, 3. LF UK, Praha

Serotonine reuptake inhibitors (SRIs) are the first line of drugs in treatment of obsessive-compulsive disorder (OCD). Choice of SRI is determined by the side effect profile. High doses and longer trials are needed for adequate response. In responders, SRIs have to be continued in the same doses for a minimum of 1-2 years and may be lifelong in those with persistent symptoms and in those with multi­ple relapses. If the first SRI trial fails to elicit response, successive SRI trials have to be considered. Failure to respond to multiple SRI trials should lead to trials with clomipramine first and venlafaxine later. In non-responders and partial responders, atypical antipsychotic agents are the first-choice augmenting drugs.

Keywords: Key words: obsessive compulsive disorder, pharmacotherapy, serotonine reuptake inhibitors, side effects, augmentation.

Published: February 1, 2009  Show citation

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Kosová J. Pharmacotherapy of obsessive-compulsive disorder. Psychiatr. praxi. 2009;10(1):31-35.
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    References

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    33. Carey PD, Vythilingum B, Seedat S, et al. Quetiapine augmentation of SRIs in treatment refractory obsessive-compulsive disorder: a double-blind, randomized, placebo-controlled study: BMC Psychiat 2005; 5(1): 5. Go to original source... Go to PubMed...
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    35. Metin Ö, Yazici K, Tot S, et al. Amisulpiride augmentation in treatment resistant obsessive-compulsive disorder: an open trial. Hum Psychopharmacology 2003; 18(6): 463-467. Go to original source... Go to PubMed...
    36. Bloch MH, Landeros-Weisenberger A, Kelmendi B, et al. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry Jul 2006; 11(7): 622-632. Go to original source... Go to PubMed...
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    49. Coric V, Taskiran S, Pittenger C, et al. Riluzole augmentation in treatment-resistant obsessive-compulsive disorder: an open label trial. Biol Psychiatry 2005; 58: 424-428. Go to original source... Go to PubMed...
    50. Kosová J. Obsedantně kompulzivní porucha. In: Höschl, Libiger, Švestka Eds. Psychiatrie Praha: Tigis 2002; 494-500.
    51. Pallanti S, Hollander E, Bienstock C, et al. Zohar and the International Treatment-Refractory OCD Consortium: Treatment non-response in OCD: methodological issues and operational definition. Int J Neuropsychopharmacol 2002; 5: 181-191. Go to original source... Go to PubMed...
    52. Math SB, Janardhan Redddy YC. Issues in the pharmacological treatment of obsessive-compulsive disorder. International Journal of Clinical Practice, 2007; 61(7): 1188-1197. Go to original source... Go to PubMed...
    53. Dell´Osso B, Altamura AC, Mundo E, et al. Diagnosis and treatment of obsessive-compulsive disorder and related disorders. International Journal of Clinical Practice 2007; 61 (1): 98-104. Go to original source... Go to PubMed...
    54. Pato PT, Zohar-Kadouch RC, Zohar J, et al. Return of symptoms after discontinuation of clomipramine in patients with obsessive-compulsive disorder. Am J Psychiatry 1988; 145: 1521-1525. Go to original source... Go to PubMed...
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    56. Pigott TA, Seay S. Pharmacotherapy of obsessive-compulsive disorder. Int Rev Psychiatry 1997; 9: 133-147. Go to original source...
    57. Clomipramine Collaborative Study Group. Clomipramine in the treatment of patients with obsessive-compulsive disorder. Arch Gen Psychiatry 1991; 48: 730-738. Go to original source... Go to PubMed...
    58. Soomro GM, Altman D, Rajagopal S, et al. Selective serotonin reuptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD). Cochrane Database Syst Rev Jan 2008; 23(1): CD001765. Go to original source... Go to PubMed...
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    61. Piccinelli M, Pini S, Bellantouono C. Efficacy of drug treatment in obsessive-compulsive disorder: a meta-analytic review. Br J Psychiatry 1995; 166: 424-443. Go to original source... Go to PubMed...
    62. Geller DA, Biederman J, Stewart SE, et al. Which SSRI? A meta-analysis of Pharmacotherapy Trials in pediatric obsessive-compulsive disorder. Am J Psychiatry 2003; 160: 1919-1928. Go to original source... Go to PubMed...
    63. Stein DJ, Spadaccni E, Hollander E. Metaanalysis of pharmacoterapy trials for obsessive-compulsive disorder. Int Clin Psychopharmacol 1995; 10: 11-18. Go to original source... Go to PubMed...
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    65. Fineberg NA a Gale T. Evidence-based pharmacological treatment for obsessive-compulsive disorder. Int J Neuropsychopharmacol 2005; 8: 107-129. Go to original source... Go to PubMed...
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    79. Bystritsky A, Ackerman DL, Rosen R, et al. Augmentation of SSRI response in refractory obsessive-compulsive disorder using adjunctive olanzapine: a placebo-controlled trial. J Clin Psychiatr 2004; 65: 565-568. Go to original source... Go to PubMed...
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    82. Fineberg NA a Gale T. Evidence-based pharmacological treatment for obsessive-compulsive disorder. Int J Neuropsychopharmacol 2005; 8: 107-129. Go to original source... Go to PubMed...
    83. Carey PD, Vythilingum B, Seedat S, et al. Quetiapine augmentation of SRIs in treatment refractory obsessive-compulsive disorder: a double-blind, randomized, placebo-controlled study: BMC Psychiat 2005; 5(1): 5. Go to original source... Go to PubMed...
    84. Denys D, Fineberg N, Carey PD, et al. Quetiapine addition in obsessive-compulsive disorder: is treatment outcome affected by type and dose of serotonin reuptake inhibitors? Biol Psychiatry Feb 1 2007; 61(3): 412-414. Go to original source... Go to PubMed...
    85. Metin Ö, Yazici K, Tot S, et al. Amisulpiride augmentation in treatment resistant obsessive-compulsive disorder: an open trial. Hum Psychopharmacology 2003; 18(6): 463-467. Go to original source... Go to PubMed...
    86. Bloch MH, Landeros-Weisenberger A, Kelmendi B, et al. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry Jul 2006; 11(7): 622-632. Go to original source... Go to PubMed...
    87. Kosová J, Praško J. Obsedantně kompulzivní porucha. In: Seifertová D, Praško J, Höschl C - Eds. Postupy v léčbě psychických poruch. Academia Medica Praegensis 2006; 233-246.
    88. Albert U, Aguglia E, Maina G, et al. Venlafaxine versus clomipramine in the treatment of obsessive-compulsive disorder: A preliminary single-blind, 12-week, controlled study. Journal of Clinical Psychiatry 2002; 63(11): 1004-1009. Go to original source... Go to PubMed...
    89. Ravizza L, Albert U, Ceregato A. Venlafaxine in OCD. Presented at the International Obsessive-Compulsive Disorder Conference. Sardinia: Italy, Mar 29 to Apr 1, 2001.
    90. Hollander E, Friedberg J, Wasserman S, et al. Venlafaxine in treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry 2003; 64(5): 546-550. Go to original source... Go to PubMed...
    91. Koran LM, Gamel NN, Choung HW, et al. Mirtazapine for obsessive-compulsive disorder: an open trial followed by double-blind discontinuation. J Clin Psychiatry 2005; 66(4): 515-520. Go to original source... Go to PubMed...
    92. Fallon BA, Liebowitz MR, Campeas R, et al. Intravenous clomipramine for obsessive-compulsive disorder refractory to oral clomipramine: A placebo-controlled study. Archivesof-General-Psychiatry 1998; 55(10): 918-924. Go to original source... Go to PubMed...
    93. Jenike MA, Baer L, Minichiello WE, et al. Placebo-controlled trial of fluoxetine and phenelzine for obsessive-compulsive disorder. American Journal of Psychiatry 1997; 154(9): 1261-1264. Go to original source... Go to PubMed...
    94. Pigott TA, L'Heureux F, Rubenstein CS. A controlled trial of clonazepam augmentation in OCD patients treated with clomipramine or fluoxetinem. Abstract presented at the annual meeting of the American Psychiatric Association: Washington DC, May 4, 1992.
    95. Pato PT, Pigott TA, Hill JL, et al. Controlled comparison of buspirone and clomipramine in obsessive-compulsive disorder. Am J Psychiatry 1991; 148: 127-129. Go to original source... Go to PubMed...
    96. Hewlett WA, Vinogradov S, Agras WS. Clomipramine, clonazepam, and clonidine treatment of obsessive-compulsive disorder. J Clin Psychopharmacology 1992; 12(6): 420-430. Go to original source...
    97. Hollander E, Kaplan A, Stahl SM. A double-blind, placebo-controlled trial of clonazepam in obsessive-compulsive disorder. World J Biol Psychiatry 2003; 4(1): 30-34. Go to original source... Go to PubMed...
    98. Fux M, Levine J, Aviv A, et al. Inositol treatment of obsessive-compulsive disorder. American Journal of Psychiatry 1996; 153(9): 1219-1221. Go to original source... Go to PubMed...
    99. Coric V, Taskiran S, Pittenger C, et al. Riluzole augmentation in treatment-resistant obsessive-compulsive disorder: an open label trial. Biol Psychiatry 2005; 58: 424-428. Go to original source... Go to PubMed...
    100. Kosová J. Obsedantně kompulzivní porucha. In: Höschl, Libiger, Švestka Eds. Psychiatrie Praha: Tigis 2002; 494-500.

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