title: Open-label study of high (30 mg) and moderate (20 mg) dose escitalopram for the treatment of obsessive-compulsive disorder.
abstract: This study sought to investigate the efficacy of escitalopram at different dosages for the treatment of obsessive-compulsive disorder (OCD). Thirty individuals were enrolled in a 16-week, open-label trial of escitalopram and randomly assigned to the 20 or 30 mg study arm. Study measures assessing OCD symptoms, anxiety, depression, and quality of life were administered at baseline and weeks 2, 4, 8, 12, and 16. For the 23 study completers, pretreatment and posttreatment analyses revealed significant improvements (P<0.05) on clinician-rated and self-rated measures of OCD symptoms, quality of life, anxiety, and depression. Approximately half of the sample (n = 12) satisfied full medication response criteria and less than one-quarter (n = 5) were partial medication responders. Intention-to-treat analyses showed similar improvements (P<0.05) on all study measures. At study completion, a superior responder rate and more improvement on the Yale-Brown Obsessive Compulsive Scale (P<0.05) was reported for those in the 30 versus 20 mg study arm. The difference between the two groups, however, disappeared when initial differences in baseline depression and anxiety scores were used as analysis covariates. These results suggest that the 30 mg (vs. 20 mg) dose of escitalopram may provide a superior reduction in OCD symptoms for those sufferers with comorbid depression and/or anxiety.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA. ddougherty@partners.org
authors.forename: Darin D
authors.initials: DD
authors.lastname: Dougherty
authors.forename: Mariko
authors.initials: M
authors.lastname: Jameson
authors.forename: Thilo
authors.initials: T
authors.lastname: Deckersbach
authors.forename: Rebecca
authors.initials: R
authors.lastname: Loh
authors.forename: Johanna
authors.initials: J
authors.lastname: Thompson-Hollands
authors.forename: Michael
authors.initials: M
authors.lastname: Jenike
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Keuthen
mesh_terms: D000293:Adolescent; D000328:Adult; D015283:Citalopram / Q000008:administration & dosage*; D003863:Depression / Q000150:complications / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000188:drug therapy*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D015283:Citalopram