title: [Evidence-based pharmacotherapy and other somatic treatment approaches for obsessive-compulsive disorder: state of the art].
abstract: Meta-analyses of the randomized controlled trials (RCT) in obsessive-compulsive disorder (OCD) have clearly demonstrated that selective serotonin reuptake inhibitors (SSRIs) are the medication treatment of choice, while cognitive behavioural therapy (CBT) with exposure and response prevention is the psychotherapy of choice in OCD. Several guidelines emphasized that SSRIs are the first choice of medication in OCD. It has been noted that these agents may need to be given at a higher dose, and for a longer duration, than is usually the case in disorders such as depression. In the management of refractory patients, medication history should be carefully reviewed and adherence to the recommendations of the guideline established. Antipsychotics (risperidone, quetiapine, haloperidol) are currently the pharmacotherapy augmentation strategy of choice. In those OCD patients who fail to respond to a range of SSRIs and augmentation strategies combined with CBT, more unusual interventions (including deep brain stimulation) can be considered.
authors.affiliation: Klinik für Psychiatrie und Psychotherapie, Medizinische Universität zu Lübeck, Lübeck, Deutschland. andreas.kordon@psychiatrie.uk-sh.de
authors.forename: A
authors.initials: A
authors.lastname: Kordon
authors.forename: B
authors.initials: B
authors.lastname: Zurowski
authors.forename: K
authors.initials: K
authors.lastname: Wahl
authors.forename: F
authors.initials: F
authors.lastname: Hohagen
mesh_terms: D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002997:Clomipramine / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D000929:Antidepressive Agents, Tricyclic; D014150:Antipsychotic Agents; D002997:Clomipramine; D017367:Selective Serotonin Reuptake Inhibitors