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Fluvoxamine versus clomipramine for obsessive-compulsive disorder: a double-blind comparison
L M Koran1, S L McElroy, J R Davidson
1Department of Psychiatry, Stanford University Medical Center, CA 94305, USA.
Journal of Clinical Psychopharmacology
|April 1, 1996
Summary
Fluvoxamine and clomipramine demonstrated equal effectiveness in treating obsessive-compulsive disorder (OCD) over 10 weeks. Both medications showed similar response rates, but with distinct side effect profiles for each drug.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Medicine
Background:
- Obsessive-compulsive disorder (OCD) is a debilitating mental health condition.
- Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants are common treatments for OCD.
- Understanding the comparative efficacy and tolerability of different pharmacotherapies is crucial for effective patient management.
Purpose of the Study:
- To compare the efficacy and tolerability of fluvoxamine and clomipramine in patients with OCD.
- To evaluate treatment response using standardized OCD assessment scales.
- To identify and compare adverse event profiles between the two medications.
Main Methods:
- A randomized, double-blind, parallel-group study involving 79 patients diagnosed with OCD.
- Patients received either fluvoxamine (100-300 mg/day) or clomipramine (100-250 mg/day) for 10 weeks after a 2-week placebo lead-in.
- Efficacy was measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and other clinical/patient global scales. Depression and somatic symptoms were also monitored.
Main Results:
- Both fluvoxamine and clomipramine groups showed significant improvement in OCD symptoms, with comparable response rates (56% for fluvoxamine vs. 54% for clomipramine).
- No statistically significant differences in efficacy were found between the two treatment groups at any point during the 10-week study.
- While overall adverse event withdrawal rates were similar, fluvoxamine was associated with more insomnia, nervousness, and dyspepsia, whereas clomipramine led to more dry mouth and postural hypotension.
Conclusions:
- Fluvoxamine and clomipramine are equally effective treatments for obsessive-compulsive disorder over a 10-week period.
- The choice between fluvoxamine and clomipramine may depend on the patient's specific side effect profile and tolerability.
- Both medications were well-tolerated, with no serious drug-related adverse events reported in this study.