An updated review of antidepressants with marked serotonergic effects in obsessive-compulsive disorder.
BACKGROUND
Since the recognition of the effectiveness of clomipramine in treating obsessive-compulsive disorder (OCD), a number of recent empirical studies have confirmed a key role of the serotonergic (5-HT) system in the pathophysiology of OCD. The current study presents a review of the existing double-blind studies testing 5-HT antidepressants in OCD.


METHODS
A systematic review was performed to identify double-blind, placebo-controlled, randomized clinical trials investigating the efficacy of antidepressants with marked 5-HT effects [clomipramine, selective serotonin reuptake inhibitors (SSRIs), venlafaxine, desvenlafaxine, duloxetine, mirtazapine, agomelatine, vortioxetine and vilazodone] in the short-term treatment of OCD. The search provided 29 studies investigating eight different 5-HT antidepressants. While the findings show reliable efficacy of clomipramine and SSRIs in the treatment of OCD symptoms, no double-blind studies were identified investigating the efficacy of desvenlafaxine, duloxetine, mirtazapine, agomelatine, vortioxetine or vilazodone.


CONCLUSIONS
While our results support the effectiveness of older antidepressants with marked 5-HT effects in OCD, it also suggests that newer agents should be tested more comprehensively.
Federal University of Rio de Janeiro, Institute of Psychiatry, Anxiety and Obsessive-Compulsive Disorders Research Program , Rua Visconde de Pirajá, 547, Sala 719, Ipanema, Rio de Janeiro, CEP: 22410-003 , Brazil +55 21 2239 4919 ; +55 21 2239 4919 ; lfontenelle@gmail.com.
Mariana
M
Pizarro
Leonardo F
LF
Fontenelle
Daniel C
DC
Paravidino
Murat
M
Yücel
Eurípedes C
EC
Miguel
Gabriela B
GB
de Menezes
D000928:Antidepressive Agents / Q000627:therapeutic use*; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
antidepressants; obsessive–compulsive disorder; pharmacological treatment; serotonin