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 functions in obsessive-compulsive disorder (OCD) because some antidepressants with strong effects on serotonin reuptake blockade fail to relieve obsessive-compulsive symptoms. We undertook a trial to investigate whether the combination of clomipramine with nortriptyline was more effective than clomipramine alone.


METHODS
Thirty patients who met the DSM-IV criteria for OCD completed the study. Patients were allocated in a random fashion, 15 each to clomipramine 150 mg/ day plus nortriptyline 50 mg/day and clomipramine 150 mg/day plus placebo.


RESULTS
Although 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 clomipramine alone in the treatment of OCD.


CONCLUSIONS
As this study indicates, a rapid onset of action is one of the advantages of this combination. This study supports further investigation of the noradrenergic-serotonergic hypothesis in OCD.
Noorbala
A A
AA
Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Iran.
Hosseini
S H
SH
Mohammadi
M R
MR
Akhondzadeh
S
S
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000328:Adult; D002997:Clomipramine / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009661:Nortriptyline / Q000627:therapeutic use*; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy*; D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D018759:Adrenergic Uptake Inhibitors; D002997:Clomipramine; D009661:Nortriptyline; D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors