PHARMACOLOGICAL TREATMENT OF OBSESSIVE-COMPULSIVE DISORDER - COMPARATIVE-STUDIES

The predominant hypothesis about obsessive-compulsive disorder (OCD) p athophysiology implicates abnormal serotonergic function regulation. P harmacologic agents with potent serotonin reuptake-inhibiting properti es have demonstrated effectiveness in treating OCD. In short-term clin ical trials compared by meta-analysis, clomipramine and serotonin sele ctive reuptake inhibitors (SSRIs) were found superior to placebo in im proving symptoms of OCD. In one-to-one comparative studies, clomiprami ne has been found as efficacious as fluoxetine and fluvoxamine, and in a comparative trial of clomipramine with sertraline, there was a stat istically superior response to sertraline after 16 weeks of treatment, moreover, discontinuation rate in patients taking clomipramine was mo re than twice that in patients taking sertraline (26% vs. 11%), In con trast to patients receiving clomipramine who showed poor tolerance in long-term use, patients maintained on fluoxetine for 24 weeks after an acute phase well tolerated the medication. In another study, patients responding to 12 weeks of sertraline treatment also showed improved t olerance during an additional 40-week period: with 75% completing the continuation phase. With long-term or even lifelong treatment appearin g necessary for people with OCD, those agents that result in better to lerance will prove preferable.