title: Pharmacotherapy of obsessive-compulsive disorder: evidence-based treatment and beyond.
abstract: BACKGROUND
  Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder associated with a significant degree of functional disability and poor quality of life. Pharmacotherapy may have a substantial impact on the course and outcome of OCD.
  
  
  METHODS
  We review the evidence supporting available strategies for the pharmacological treatment of OCD.
  
  
  RESULTS
  Selective serotonin reuptake inhibitors (SSRIs) remain the pharmacological treatment of choice and are associated with improved health-related quality of life. Discontinuation is associated with relapse and loss of quality of life, implying treatment should continue long-term. A substantial minority of patients who fail to respond to SSRI may benefit from dose elevation or adjunctive antipsychotics, though long-term trials validating the effectiveness and tolerability of these strategies are relatively lacking.
  
  
  CONCLUSIONS
  The pharmacological evidence-base for the treatment of OCD is becoming increasingly robust. Treatment with SSRIs and clomipramine remains uncontroversial and improvements are sustained over time. Newer compounds targeting serotonin receptor subtypes and other neurotransmitter systems are undergoing evaluation.
authors.affiliation: 1Mental Health Unit, Hertfordshire Partnership Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, UK.
authors.forename: Naomi A
authors.initials: NA
authors.lastname: Fineberg
authors.forename: Samar
authors.initials: S
authors.lastname: Reghunandanan
authors.forename: Angus
authors.initials: A
authors.lastname: Brown
authors.forename: Ilenia
authors.initials: I
authors.lastname: Pampaloni
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D002997:Clomipramine / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy*; D012008:Recurrence; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
chemical_list: D014150:Antipsychotic Agents; D002997:Clomipramine; D017367:Selective Serotonin Reuptake Inhibitors