PHARMACOLOGICAL MANAGEMENT OF OBSESSIVE-COMPULSIVE DISORDER

Obsessive-compulsive disorder (OCD) is an intriguing, difficult proble m characterized by anxiety-producing intrusive thoughts and performanc e of anxiety-reducing rituals. Current evidence suggests that OCD may be associated with dysregulation of serotonin and dopamine neurotransm ission. Numerous early studies involving the serotonin-specific reupta ke inhibitor clomipramine led to the formulation of this hypothesis. P ositive results with clomipramine initiated further research with othe r serotonin-specific reuptake inhibitors, such as fluoxetine, fluvoxam ine, sertraline, and serotonergic agents such as buspirone and trazodo ne. Findings from a number of clinical trials suggest that drugs that inhibit serotonin reuptake or affect serotonergic transmission in othe r ways are of clear benefit in the treatment of OCD. These drugs may b e more effective for obsessive thoughts that for compulsive rituals. E ffective pharmacotherapy can dramatically decrease obsessive-compulsiv e symptoms and improve the patient's quality of life.