CLINICAL CHARACTERISTICS OF RESPONSE TO FLUOXETINE TREATMENT OF OBSESSIVE-COMPULSIVE DISORDER

Fluoxetine is effective in treating obsessive-compulsive disorder (OCD ). Nonetheless, a substantial number of patients do not respond or hav e only partial improvement. Data generated by a multicenter, placebo-c ontrolled, fixed-dose trial of fluoxetine were reanalyzed to identify characteristics of responders. Multiple regression methods were used t o evaluate the relationship between therapeutic response and baseline measures such as; severity of-symptoms, type of symptoms (obsessions, compulsions, depression), course of illness, previous treatment, age o f onset, and other demographic factors (age, race, and sex). Fluoxetin e was more effective than placebo on all outcome measures. A 60-mg dos age was associated with a greater drop in Yale-Brown Obsessive-Compuls ive Scale total score and a greater drop in Compulsion items than a 20 -mg dosage. Response rates and overall improvement were greatest for p atients with a history of remissions, with no previous drug treatment or with only prior behavior therapy, with more severe OCD (especially with greater interference and distress from obsessions), or with eithe r low or high Hamilton Rating Scale for Depression scores. This study did not detect any associations between response and current age, age of OCD onset, gender, and race. None of the demographic or clinical fa ctors evaluated was found to be related to improvement in the placebo group.