Pharmacotherapy of obsessive-compulsive disorder: Evidence-based treatment and beyond. (February 2013)

• Record Type: Journal Article
• Authors: Fineberg, Naomi A; Reghunandanan, Samar; Brown, Angus; Pampaloni, Ilenia
• Is Part Of: Australian and New Zealand journal of psychiatry. Volume 47:Number 2(2013)
• Page Start: 121
• Page End: 141
• Publication Date: 2013-02
• Subjects: Clinical trials -- meta-analysis -- obsessive compulsive disorder -- randomised control -- systematic reviews; Psychiatry -- Periodicals; Psychiatry -- Australia -- Periodicals; Psychiatry -- New Zealand -- Periodicals; 616.89005
• DOI: 10.1177/0004867412461958
• Languages: English
• ISSNs: 0004-8674

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. Method: 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. Conclusion: 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.