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Intravenous anti-obsessive agents: a review.

L N Ravindran1, S M Jung, A V Ravindran

  • 1Department of Psychiatry, VA San Diego Health Care System, San Diego, California, USA. arun_ravindran@camh.net

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Psychiatry

Background:

  • Oral antidepressants are first-line OCD treatment but have limitations.
  • Low response rates and delayed therapeutic action are common with oral antidepressants.
  • Intravenous (i.v.) agents are being explored for faster and potentially greater efficacy.

Purpose of the Study:

  • To review existing literature on i.v. antidepressant use for OCD.
  • To assess the efficacy and tolerability of i.v. anti-obsessive agents.
  • To identify potential benefits for treatment-refractory OCD patients.

Main Methods:

  • A Medline search was conducted for studies on i.v. antidepressants for OCD.
  • Search terms included various i.v. antidepressants and related terms.
  • Relevant articles primarily focused on clomipramine (CMI) and citalopram.

Main Results:

  • Intravenous agents were generally well-tolerated, especially in non-responders to oral therapy.
  • Initial clinical response may be faster with i.v. administration, but this advantage may diminish over time.
  • Preliminary data suggest potential benefits for severe, treatment-refractory OCD with i.v. CMI and citalopram.

Conclusions:

  • Intravenous antidepressants show promise for faster onset and potential efficacy in specific OCD populations.
  • Further large-scale, controlled trials are necessary to confirm these findings.
  • I.v. agents may be a viable option for patients with severe treatment-refractory OCD.