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
Efficacy of Serotonergic vs Adrenergic Antidepressants
While anecdotal reports have suggested that clinical benefit can be obtained with a range of antidepressant medications, consistent efficacy has only been demonstratedfor SRIs and SSRIs. Studies have directly compared CMI with other antidepressants and a consistent pattern emerges: antidepressant drugs that are less potent serotonin reuptake inhibitors than CMI are generally ineffective in OCD. Clomipramine (CMI) was the first effective medication reported for OCD, in the late 1960s. Since then, numerous placebo-controlled studies have clearly shown CMI’s effectiveness. This culminated in the multi-center, controlled US trial (N= 520) that confirmed CMI’s effectiveness (Clomipramine ollaborative Study Group. In this study, after 10 weeks of treatment, 58% of patients treated with CMI rated themselves much or very much improved, versus 3% of placebo-treated patients. Beside CMI, other non-tricyclic SRIs, such as fluoxetine, fluvoxamine, paroxetine, sertraline and citalopram are gaining acceptance as effective alternatives for the treatment of OCD in controlled studies.