COMBINATION OF CLOMIPRAMINE AND NORTRIPTYLINE IN THE TREATMENT OF OBSESSIVE-COMPULSIVE DISORDER - A DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL

Objective: There is growing interest in investigating noradrenergic fu nctions in obsessive-compulsive disorder (OCD) because some antidepres sants with strong effects on serotonin reuptake blockade fail to relie ve obsessive-compulsive symptoms. We undertook a trial to investigate whether the combination of clomipramine with nortriptyline was more ef fective than clomipramine alone. Method: Thirty patients who met the D SM-IV criteria for OCD completed the study. Patients were allocated in a random fashion, 15 each to clomipramine 150 mg/day plus nortriptyli ne 50 mg/day and clomipramine 150 mg/day plus placebo. Results: Althou gh both protocols significantly decreased the scores of the Yale-Brown obsessive-compulsive scale over the trial period, the combination of clomipramine and nortriptyline showed a significant superiority over c lomipramine alone in the treatment of OCD. Conclusion: As this study i ndicates, a rapid onset of action is one of the advantages of this com bination. This study supports further investigation of the noradrenerg ic-serotonergic hypothesis in OCD.