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Evidence-based pharmacotherapy for obsessive–compulsive disorder

Published online by Cambridge University Press:  02 January 2018

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The development of effective pharmacotherapy has revolutionised the treatment of obsessive–compulsive disorder (OCD), and has generated an explosion of interest in this previously poorly understood area of psychiatry. Once considered a rare, refractory form of learnt behaviour, we now recognise OCD to be a common, treatable illness, with a distinctive pathophysiology and pharmacology. Wide-ranging epidemiological surveys have demonstrated a surprisingly high lifetime prevalence amounting to 2–3% of the general population worldwide (Robins et al, 1984). Yet only a fraction of sufferers come forward for treatment and often the diagnosis is missed.

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Research Article
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Copyright © The Royal College of Psychiatrists 1999 

References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn). Washington, DC: APA.Google Scholar
Asberg, M., Montgomery, S. A., Perris, C. et al (1978) A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica, suppl. 271, 527.CrossRefGoogle Scholar
Bisserbe, J. C., Lane, R. M., Flament, M. F. et al (1997) A double-blind comparison of sertraline and clomipramine in outpatients with obsessive compulsive disorder. European Psychiatry, 153, 14501454.Google Scholar
Cottraux, J., Mollard, E., Bouvard, M. et al (1990) A controlled study of fluvoxamine and exposure in obsessive compulsive disorders. International Clinical Psychopharmacology, 5, 1730.CrossRefGoogle Scholar
Dunbar, G., Steiner, M., Bushnell, W. D. et al (1995) Long-term treatment and prevention of relapse of obsessive compulsive disorder with paroxetine. European Neuropsychopharmacology, 5, 372.CrossRefGoogle Scholar
Fineberg, N. A. & Montgomery, S. A. (1992) Serotonin reuptake inhibitors are the treatment of choice in obsessive compulsive disorder. International Clinical Psychopharmacology, 7 (Suppl. 1), 4347.CrossRefGoogle ScholarPubMed
Fineberg, N. A., Roberts, N. A. & Montgomery, S. A. (1994) Are higher doses more effective in OCD? European Neuropsychopharmacology, 4, 264265.CrossRefGoogle Scholar
Fineberg, N. A. & Drummond, L. M. (1995) Anxiety disorders: drug treatment or behavioural cognitive psychotherapy? CNS Drugs, 3, 448466.CrossRefGoogle Scholar
Fineberg, N. A., Roberts, A., Montgomery, S. A. et al (1997) Brain 5-HT function in obsessive–compulsive disorder. Prolactin responses to d-fenfluramine. British Journal of Psychiatry, 171, 280282.CrossRefGoogle ScholarPubMed
Goodman, W. K., Price, L. H., Rasmussen, S. A. et al (1984) The Yale Brown Obsessive Compulsive Scale I: development, use and reliability. Archives of General Psychiatry, 46, 10061011.CrossRefGoogle Scholar
Goodman, W. K., Price, L. H., Delgado, P. et al (1990) Specificity of serotonin reuptake inhibitors in the treatment of obsessive compulsive disorder: comparison of fluvoxamine and desipramine. Archives of General Psychiatry, 47, 577585.CrossRefGoogle ScholarPubMed
Greist, J., Chouinard, G., Duboff, E. et al (1995) Double-blind parallel comparison of three dosages of sertraline and placebo in outpatients with obsessive compulsive disorder. Archives of General Psychiatry, 52, 289295.CrossRefGoogle ScholarPubMed
Hohagen, F., Winkelmann, G., Rasche-Räuchle, H. et al (1998) Combination of behaviour therapy with fluvoxamine in comparison with behaviour therapy and placebo. Results of a multicentre study. British Journal of Psychiatry, 173 (suppl. 35), 7178.CrossRefGoogle Scholar
James, I.A. & Blackburn, I.-M. (1995) Cognitive therapy with obsessive–compulsive disorder. British Journal of Psychiatry, 166, 444450.CrossRefGoogle ScholarPubMed
Jenike, M. A. & Rauch, S. L. (1994) Managing the patient with treatment-resistant obsessive compulsive disorder; current strategies. Journal of Clinical Psychiatry, 55 (suppl. 3), 1117.Google ScholarPubMed
Jenike, M. A., Baer, L., Minichiello, W. E. et al (1997) Placebo-controlled trial of fluoxetine and phenelzine for obsessive–compulsive disorder. American Journal of Psychiatry, 154, 12611264.Google ScholarPubMed
Lindsay, M., Crino, R. & Andrews, G. (1997) Controlled trial of exposure and response-prevention in obsessive–compulsive disorder. British Journal of Psychiatry, 171, 135139.CrossRefGoogle ScholarPubMed
Marks, I. M., Stern, R. S., Mawson, D. et al (1980) Clomipramine and exposure for obsessive–compulsive rituals. British Journal of Psychiatry, 136, 125.CrossRefGoogle ScholarPubMed
Montgomery, S. A. (1980) Clomipramine in obsessional neurosis; a placebo-controlled trial. Pharmacological Medicine, 1, 189192.Google Scholar
Montgomery, S. A. (1998) Psychopharmacology of obsessive–compulsive disorder. CNS Spectrums, 3 (suppl. 1), 3337.CrossRefGoogle Scholar
Montgomery, S. A. & Montgomery, D.B. (1980) Measurement of change in psychiatric illness: new obsessional, schizophrenia and depression scales. Postgraduate Medical Journal, suppl. 1, 5052.Google Scholar
Montgomery, S. A., Fineberg, N. & Montgomery, D. B. (1990) The efficacy of serotonergic drugs in OCD – power calculations compared with placebo. In Current Approaches, Obsessive Compulsive Disorder (eds Montgomery, S. A., Goodman, W. K. & Goeting, N.) pp. 5463. Southampton: Ashford Colour Press for Duphar Medical Relations.Google Scholar
Mundo, E., Bareggi, S. R., Pirola, R. et al (1997) Long-term pharmacotherapy of obsessive compulsive disorder; a double-blind controlled study. Journal of Clinical Psychopharmacology, 17, 410.CrossRefGoogle ScholarPubMed
Pato, M. T., Zohar-Kadouch, R., Zohar, J. et al (1988) Return of symptoms after discontinuation of clomipramine in patients with obsessive compulsive disorder. American Journal of Psychiatry, 145, 15211525.Google ScholarPubMed
Rasmussen, S., Eisen, J. & Pato, M. (1994) Current issues in the pharmacologic management of obsessive compulsive disorder. Journal of Clinical Psychiatry, 54 (suppl. 1), 49.Google Scholar
Robins, L. N., Holzer, J. E., Weissman, M. M. et al (1984) Lifetime prevalence of specific psychiatric disorders in three sites. Archives of General Psychiatry, 41, 949958.CrossRefGoogle ScholarPubMed
Romano, S., Goodman, W. K., Tamura, T. et al (1998) Long-term treatment of obsessive–compulsive disorder following acute response; a comparison of fluoxetine versus placebo. European Neuropsychopharmacology, 8 (suppl. 2), 261.CrossRefGoogle Scholar
Thoren, P., Asberg, M., Cronholm, B. et al (1980) Clomipramine treatment and obsessive compulsive disorder. Archives of General Psychiatry, 37, 12811285.CrossRefGoogle ScholarPubMed
Ushijima, S., Kamijima, K., Asai, M. et al (1997) Clinical evaluation of sertraline hydrochloride, a selective serotonin reuptake inhibitor, in the treatment of obsessive–compulsive disorder; a placebo-controlled trial. Japanese Journal of Neuropsychopharmacology, 19, 603623.Google Scholar
World Health Organization (1992) The ICD–10 Classification of Mental and Behavioural Disorders. Geneva: WHO.Google Scholar
Wood, A., Tollefson, G. D. & Burkitt, M. (1993) Pharmacotherapy of obsessive compulsive disorder – experience with fluoxetine. International Clinical Psychopharmacology, 8, 301306.CrossRefGoogle ScholarPubMed
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