Obsessive Compulsive Disorder
- Epidemiology
- Comorbidity
- OCD and Tic Disorder
- OCD and Depression
- OCD and Other Anxiety Disorders
- OCD and Phobia
- OCD and OCPD
- OCD and Schizophrenia
- Course and Prognosis
- Etiology
- Specific Clinical Response
- Serotonin Antagonists
- Pharmacological Challenges
- Dopamine
- Immune Factors
- Brain Imaging Studies
- Genetics
- Other Biological Data
- Behavioral Factors
- Psychosocial Factors
- Treatment of OCD
- Efficacy of Serotonergic vs Adrenergic Antidepressants
- Long Term Treatment of OCD
- Drug Dosage
- Psychological Approaches
- Treatment Resistant OCD
- Switching Medications
- Augmentation
- Risperidone
- Pindolol
- Other Options
- Intravenous Clomipramine
- Monoamine Oxidase Inhibitors
- Last-line Therapies
Other Options for Obsessive Compulsive Disorder
AsOCDis considered an anxiety disorder by the DSM-IV (but not by the ICD-10), it is not surprising that anxiolitics have been suggested in the treatment of OCD patients. Thus, alprazolam and clonazepam have been reported as efficient in several uncontrolled studies and case series, and even in a small double-blind randomized, multiple cross-over study. However, since OCD is a chronic disorder, the use of anxiolitics for long periods raises questions of dependency brought about by longterm use of benzodiazepines. Despite reports in open studies regarding the efficacy of trazodone, buspirone and lithium, the results in double-blind studies were negative. Adding drugs affecting dopamine function, especially atypical antipsychotics (risperidone), to SRI therapy in treatment-resistant OCD patients, resulted in improvement in patients with a personal or family history of tics. Thyroid supplementation has been reported to be efficacious in open trials as adjunctive agents to SRIs.
However, the efficacy of this agent in OCD was not confirmed in a controlled study. Clonidine, an alpha-2 adrenergic agonist, has been reported to be effective in treating OC symptoms in the context of Tourette’s syndrome and there are reports of improvement in typical OCD patients . However, there are no controlled data to support this agent’s efficacy and its side-effect profile discourages its use in OCD.