Trazodone treatment in clomipramine-resistant obsessive-compulsive disorder

Trazodone (TZ) was administered to nine patients suffering from obsessive-compulsive disorder (OCD), who failed to respond to either clomipramine (CMI) or to CMI plus lithium carbonate. The group, as a whole, showed significant but mild improvement. Three patients responded very favorably to TZ. In these three responders, efficacy was substantiated by the return of the original obsessive-compulsive (OC) symptoms following TZ withdrawal and their amelioration after its readministration. Interestingly, the aggravation of OCD symptomatology that has been associated with a specific TZ metabolite was not observed. This study is consistent with previous reports of the anti-OC efficacy of TZ and suggests the involvement of complex serotonergic mechanisms in the pathophysiology of this disorder.