CLOMIPRAMINE VS FLUOXETINE IN OBSESSIVE-COMPULSIVE DISORDER - AN UNCONTROLLED STUDY

In this nonblind sequential study, the efficacy and safety of clomipra mine were compared with those of fluoxetine in 22 patients (11 in each group) with obsessive-compulsive disorder (OCD). Admission to the stu dy was based on results of a clinical interview, DSM-III-R criteria fo r OCD, a minimum score of 15 on the Yale Brown Obsessive-Compulsive Sc ale (YBOCS), and presence of both obsessions and compulsions. The YBOC S was completed prior to drug treatment and at the time of discontinua tion or after 12 weeks. At the end of the study, total YBOCS score sho wed a mean improvement of 32.9% in the clomipramine group and 11.3% in the fluoxetine group. The drugs had different side-effects profiles. Fluoxetine is a pure serotonin uptake inhibitor, whereas clomipramine affects both norepinephrine and serotonin. The fact that a ''mixed'' d rug alleviated OCD symptoms better than a pure serotonin uptake inhibi tor underscores the complex etiology of OCD and suggests the involveme nt of multiple neurohormones. More conclusive results regarding the ef ficacy of various serotonin uptake inhibitors must come from a large p lacebo-controlled double-blind study.