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Pharmacotherapy for obsessive-compulsive disorder

J H Greist1, J W Jefferson

  • 1University of Wisconsin Medical School, Madison 53717-1914, USA.

The British Journal of Psychiatry. Supplement
|November 26, 1998
PubMed
Summary
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Selective serotonin reuptake inhibitors (SSRIs) are the primary pharmacotherapy for obsessive-compulsive disorder (OCD). While other treatments exist, SSRIs offer the most effective and well-tolerated options for managing OCD symptoms.

Area of Science:

  • Psychiatry
  • Pharmacology

Background:

  • Pharmacotherapy for obsessive-compulsive disorder (OCD) was limited before the advent of potent selective serotonin reuptake inhibitors (SSRIs).
  • Advances in pharmacotherapy have significantly improved treatment efficacy for a majority of OCD patients.

Purpose of the Study:

  • To review the current landscape of pharmacotherapy for obsessive-compulsive disorder.
  • To evaluate the efficacy and tolerability of various pharmacological interventions for OCD.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) for OCD pharmacotherapy.
  • Inclusion of data from open trials and case reports detailing beneficial pharmacotherapy.

Main Results:

  • Selective serotonin reuptake inhibitors (SSRIs) demonstrate good tolerability in OCD patients, even at high doses.

Related Experiment Videos

  • Antipsychotic augmentation shows promise for OCD patients with comorbid tics, whereas proserotonergic augmentation is generally less effective.
  • Potent SSRIs are the preferred pharmacotherapy for OCD, with monoamine oxidase inhibitors having a secondary role.

    • Conclusions:

    • Potent SSRIs are the first-line pharmacotherapy for obsessive-compulsive disorder.
    • Switching to a different SSRI may be beneficial if initial treatment is ineffective.
    • Behavioral therapy and, in refractory cases, neurosurgery are important adjunctive or alternative treatments for OCD.