Pharmacotherapy of obsessive compulsive disorder.
The authors briefly review studies of the efficacy of potent serotonin reuptake inhibitors (SRIs) (e.g., clomipramine, fluvoxamine) in obsessive compulsive disorder (OCD) and compare the use of antidepressants in the treatment of depression and OCD. They propose an algorithm for those patients with OCD who fail to respond to an adequate trial with a potent SRI and discuss the promise and limitations of adding tryptophan, fenfluramine, lithium, buspirone, or a neuroleptic to ongoing SRI therapy. Other biological approaches (e.g., ECT, psychosurgery) are considered in terms of their narrowly defined roles in the treatment of patients with SRI-resistant OCD.
Goodman
W K
WK
Clinical Neuroscience Research Unit, Yale University School of Medicine, New Haven, CT 06519.
McDougle
C J
CJ
Price
L H
LH
D015057:1-Naphthylamine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D002997:Clomipramine / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy; D005473:Fluoxetine / Q000627:therapeutic use; D016666:Fluvoxamine / Q000627:therapeutic use; D006801:Humans; D014179:Neurotransmitter Uptake Inhibitors / Q000627:therapeutic use*; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D017374:Paroxetine; D010880:Piperidines / Q000627:therapeutic use; D012701:Serotonin / Q000502:physiology*; D020280:Sertraline
D000928:Antidepressive Agents; D014179:Neurotransmitter Uptake Inhibitors; D010880:Piperidines; D005473:Fluoxetine; D012701:Serotonin; D017374:Paroxetine; D015057:1-Naphthylamine; D002997:Clomipramine; D016666:Fluvoxamine; D020280:Sertraline