PHARMACOTHERAPY FOR OBSESSIVE-COMPULSIVE DISORDER

Background Pharmacotherapy for obsessive-compulsive disorder (OCD) was seldom beneficial before clomipramine, a potent selective serotonin r euptake inhibitor (SSRI), became available. Subsequent progress in pha rmacotherapy for OCD has increased the possibility of effective treatm ent for most sufferers. Method Randomised controlled trials of pharmac otherapy for OCD were reviewed, as well as reports of beneficial pharm acotherapy found in open trials and case reports. Results SSRIs are we ll-tolerated by patients with OCD, even in large doses. Proserotonergi c augmentation is seldom helpful but antipsychotic augmentations seem beneficial for many OCD patients with comorbid ties. Conclusions Poten t SSRIs are the pharmacotherapy of choice for OCD, with a more limited role reserved for monoamine oxidase inhibitors. if one SSRI is ineffe ctive, others may be beneficial. Non-drug therapies are also important in OCD: behaviour therapy is frequently helpful but infrequently avai lable and neurosurgery is sometimes helpful when all other treatments have failed.