Update on pharmacologic management of OCD: agents and augmentation.
A preponderance of patients with obsessive-compulsive disorder (OCD) experience little or no improvement in their symptoms when treated with serotonin reuptake inhibitors (SRIs). It is hypothesized that SRI-refractory patients may have altered serotonin neurotransmission different from patients responsive to SRIs, or that they may have abnormalities in their dopamine function. When drugs affecting serotonin function (e.g., tryptophan, fenfluramine, lithium, buspirone) are added to SRI therapy in SRI-refractory patients, results are mixed and not consistently encouraging. However, when drugs affecting dopamine function (e.g., pimozide, haloperidol, risperidone) are added to SRI therapy in SRI-refractory OCD patients, individuals with either a personal history or family history of tics experience a reduction in their symptoms.
McDougle
C J
CJ
Department of Psychiatry, Yale University School of Medicine, New Haven, Conn., USA.
D002986:Clinical Trials as Topic; D003024:Clozapine / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005277:Fenfluramine / Q000627:therapeutic use; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000523:psychology; D018490:Serotonin Agents / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D014364:Tryptophan / Q000627:therapeutic use
D003024:Clozapine; D015259:Dopamine Agents; D005277:Fenfluramine; D006220:Haloperidol; D008094:Lithium; D018490:Serotonin Agents; D017367:Selective Serotonin Reuptake Inhibitors; D014364:Tryptophan