PSYCHOPHARMACOLOGY OF COMORBID OBSESSIVE-COMPULSIVE DISORDER AND DEPRESSION

A high degree of comorbidity appears to exist between obsessive-compul sive disorder (OCD) and depression, both with respect to symptomatolog y and at the syndromal level. It has been argued that nonspecific effe cts on dysphoric mood, anxiety, and depressive symptoms account for th e therapeutic efficacy of antidepressants in OCD. However, several con trolled studies have shown that neither the presence nor initial sever ity of depression has any impact on therapeutic improvement in OCD. In particular, studies with the serotonin selective reuptake inhibitors (SSRIs) fluvoxamine and fluoxetine have revealed beneficial effects in OCD, irrespective of the presence of depressive symptoms. The efficac y of the other SSRIs in OCD requires further study. In conclusion, the improvement in OC symptoms seen with fluvoxamine and fluoxetine does not depend on concomitant affective disorder.