DRUG-THERAPY AND CEREBRAL PERFUSION IN OBSESSIVE-COMPULSIVE DISORDER

Cerebral perfusion in a previously untreated patient with obsessive-co mpulsive disorder was studied qualitatively and semiquantitatively wit h SPECT before, during and 6 wk after treatment with clomipramine. The patient's symptoms disappeared while on medication and relapsed after drug withdrawal, At baseline, there was an increased perfusion ratio in the bilateral orbitofrontal, anterior cingular, frontotemporal and right caudate regions. These alterations disappeared during drug thera py. After treatment discontinuation and symptomatic relapse, the same pattern of hyperactivity was found. Semiquantitative measurements afte r treatment withdrawal showed a return to perfusion values similar to those observed before treatment in subcortical structures, In cortical areas, this level was not completely achieved. Subtraction SPECT imag es showed perfusion changes at the orbitofrontal, caudate and thalamic levels.