Multicentre, double-blind, comparison of fluvoxamine and clomipramine in the treatment of obsessive-compulsive disorder

The aim of this prospectively randomized, double-blind, parallel group, mul ticentre study was to compare the efficacy and tolerability of fluvoxamine and clomipramine in patients suffering from obsessive-compulsive disorder ( OCD) (DSM-III-R). Fourteen centres participated in this trial. Sixty-eight patients were randomized to receive fluvoxamine and 65 to receive clomipram ine. The duration of the study was 10 weeks. The two treatment groups showe d a marked improvement of obsessive-compulsive symptomatology, as determine d by the Yale-Brown obsessive-Compulsive Scale, the National Institute of M ental Health Obsessive-Compulsive Global Scale and Clinical Global Impressi on. No statistically significant differences were found between fluvoxamine and clomipramine in terms of efficacy during the study. A similar number o f patients in each group withdrew from the study prematurely, but there wer e more dropouts due to adverse events in the clomipramine group. Concerning tolerability, there were significantly more reports of constipation and dr y mouth in the clomipramine group. The results show that fluvoxamine and cl omipramine have similar efficacy in the treatment of patients suffering fro m OCD, but fluvoxamine is better tolerated. In view of the superior safety profile of fluvoxamine compared to clomipramine in terms of a risk-benefit assessment, the use of fluvoxamine would appear to be advantageous for this patient population. (C) 2000 Lippincott, Williams and Wilkins.