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Pharmacotherapy for obessive-compulsive disorder

Published online by Cambridge University Press:  06 August 2018

John H. Greist  and
James W. Jefferson
John H. Greist*
Affiliation:
University of Wisconsin Medical School, and Dean Foundation for Health, Research and Education, 8000 Excelsior Drive, Suite 302, Madison, Wl 53717–1914. Fax: (608) 833–8033
James W. Jefferson
Affiliation:
University of Wisconsin Medical School, and Dean Foundation for Health, Research and Education, 8000 Excelsior Drive, Suite 302, Madison, Wl 53717–1914. Fax: (608) 833–8033
*
Correspondence: J. H. Greist, University of Wisconsin Medical School, 8000 Excelsior Drive, Suite 302, Madison, Wl 53717–1914, USA
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Abstract

Background Pharmacotherapy for obsessive-compulsive disorder (OCD) was seldom beneficial before clomipramine, a potent selective serotonin reuptake inhibitor (SSRI), became available. Subsequent progress in pharmacotherapy for OCD has increased the possibility of effective treatment for most sufferers.

Method Randomised controlled trials of pharmacotherapy for OCD were reviewed, as well as reports of beneficial pharmacotherapy found in open trials and case reports.

Results SSRIs are well-tolerated by patients with OCD, even in large doses. Prose roto n erg i c augmentation is seldom helpful but antipsychotic augmentations seem beneficial for many OCD patients with comorbid tics.

Conclusions Potent SSRIs are the pharmacotherapy of choice for OCD, with a more limited role reserved for monoamine oxidase inhibitors. If one SSRI is ineffective, others may be beneficial. Non-drug therapies are also important in OCD: behaviour therapy is frequently helpful but infrequently available and neurosurgery is sometimes helpful when all other treatments have failed.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 173 , Issue S35: New perspectives in research and treatment of obsessive-compulsive disorder , August 1998 , pp. 64 - 70
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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