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The Medical Treatment of Obsessive-Compulsive Disorder and Anxiety

Published online by Cambridge University Press:  07 November 2014

Borwin Bandelow
Borwin Bandelow*
Affiliation:
Dr. Bandelow is professor of psychiatry in the Department of Psychiatry and Psychotherapy at the University of Göttingen in, Germany
*
Department of Psychiatry and Psychotherapy, The University of Göttingen, von-Siebold-Str. 5, 37075 Göttingen, GermanyE-mail, [email protected]
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Abstract

Selective serotonin reuptake inhibitors (SSRIs) are first-line pharmacotherapy treatments for obsessive-compulsive disorder (OCD). Clomipramine is effective in OCD but associated with more adverse events. Typically, higher doses of antidepressants are required for OCD. Up to 50% of patients do not respond to initial treatment of OCD. Treatment options for nonresponders include augmentation of antidepressants with atypical antipsychotics, among other strategies. First-line treatments for anxiety disorders include SSRIs, serotonin norepinephrine reuptake inhibitors, and pregabalin. Tricyclic antidepressants are equally effective as SSRIs, but are less well tolerated. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of dependency and tolerance. Other treatment options include irreversible and reversible monoamine oxidase inhibitors, the atypical antipsychotic quetiapine, and other medications. Cognitive-behavioral therapy has been sufficiently investigated in controlled studies of OCD and anxiety disorders and is recommended alone or in combination with the above medications.

Type
Research Article
Information
CNS Spectrums , Volume 13 , Issue S14 , 2008 , pp. 37 - 46
Copyright
Copyright © Cambridge University Press 2008

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