Pharmacotherapy for obsessive-compulsive disorder.
BACKGROUND
Pharmacotherapy for obsessive-compulsive disorder (OCD) was seldom beneficial before clomipramine, a potent selective serotonin reuptake inhibitor (SSRI), became available. Subsequent progress in pharmacotherapy for OCD has increased the possibility of effective treatment for most sufferers.


METHODS
Randomised controlled trials of pharmacotherapy for OCD were reviewed, as well as reports of beneficial pharmacotherapy found in open trials and case reports.


RESULTS
SSRIs are well-tolerated by patients with OCD, even in large doses. Proserotonergic augmentation is seldom helpful but antipsychotic augmentations seem beneficial for many OCD patients with comorbid tics.


CONCLUSIONS
Potent SSRIs are the pharmacotherapy of choice for OCD, with a more limited role reserved for monoamine oxidase inhibitors. If one SSRI is ineffective, others may be beneficial. Non-drug therapies are also important in OCD: behaviour therapy is frequently helpful but infrequently available and neurosurgery is sometimes helpful when all other treatments have failed.
Greist
J H
JH
University of Wisconsin Medical School, Madison 53717-1914, USA.
Jefferson
J W
JW
D001569:Benzodiazepines / Q000627:therapeutic use*; D006801:Humans; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use*; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D001569:Benzodiazepines; D008996:Monoamine Oxidase Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors