Venlafaxine versus clomipramine in the treatment of obsessive-compulsive disorder: a preliminary single-blind, 12-week, controlled study.
BACKGROUND
The objective of this study was to investigate, in a single-blind manner over a period of 12 weeks, the efficacy and tolerability of venlafaxine versus clomipramine in the treatment of obsessive-compulsive disorder (OCD).


METHODS
Patients with a DSM-IV diagnosis of OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) score >/= 16 were randomly assigned to receive venlafaxine, 225 to 350 mg/day (26 patients), or clomipramine, 150 to 225 mg/day (47 patients), for 12 weeks, with dosage adjustments according to tolerability and response to treatment. All patients were medication-free from at least 2 months prior to study enrollment. Efficacy measures were the YBOCS and the Clinical Global Impressions scale (CGI), which were completed at baseline and every 4 weeks. We defined responders as patients who had an improvement from baseline in YBOCS score of >/= 35% and a CGI score </= 2. An investigator who was blinded to patients' current medication administered rating scales independently. Moreover, patients were instructed not to reveal their current treatment to this investigator.


RESULTS
Twenty-five patients in the venlafaxine group and 40 in the clomipramine group completed the 12-week trial. Responder rates at the end of the 12 weeks were 36% for venlafaxine (9/25) versus 50% for clomipramine (20/40) according to the visitwise analysis and 34.6% (9/26) for venlafaxine versus 42.6% (20/47) for clomipramine according to the last-observation-carried-forward analysis, with no statistically significant difference between the 2 drugs. Adverse experiences were reported by 61.5% of patients receiving venlafaxine (16/26) and by 91.5% of those receiving clomipramine (43/47).


CONCLUSIONS
Our results indicate that venlafaxine might be as efficacious as clomipramine in the acute treatment of OCD, with fewer side effects.
Albert
Umberto
U
Anxiety and Mood Disorders Unit, Department of Neurosciences, University of Turin, Italy.
Aguglia
Eugenio
E
Maina
Giuseppe
G
Bogetto
Filippo
F
D000208:Acute Disease; D000328:Adult; D000553:Ambulatory Care; D002997:Clomipramine / Q000009:adverse effects / Q000627:therapeutic use*; D003511:Cyclohexanols / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D010552:Personality Assessment; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016037:Single-Blind Method; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
D002997:Clomipramine; D003511:Cyclohexanols; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride