OBSESSIVE-COMPULSIVE DISORDER IN ELDERLY PATIENTS

Obsessive-compulsive disorder (OCD) is a common illness which starts i n young adulthood and persists into late life. OCD is associated with dysregulation of the serotonin system and may also be related to the d ysregulation of dopamine. When OCD starts in an elderly patient, eithe r an organic or a neurological diagnosis should be considered. Clomipr amine and serotonin reuptake inhibitors are the mainstay of treatment for OCD. Choice of a particular agent should be based on the patient's previous response and the adverse effect profile of the drug. Pharmac okinetics should also be a consideration due to age-related changes in hepatic and renal function leading to increased plasma concentrations as well as prolonged elimination half-lives of these agents. Behaviou ral therapy, in addition to pharmacological management, is essential t o treat compulsions and to improve response.