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Obsessive-Compulsive Disorder: An Open-Label Pilot Trial of Escitalopram

Published online by Cambridge University Press:  07 November 2014

Amanda Galvão-de Almeida ,
Lucas C. Quarantini ,
Cristianne R. Góis ,
Rogério Santos-Jesus ,
Ângela M.A. Miranda-Scippa ,
Irismar R. de Oliveira ,
Helena da Silva Prado ,
James F. Leckman  and
Maria C. Rosário
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Abstract

Introduction: Selective serotonin reuptake inhibitors are considered the most effective and well-established pharmacotherapy for the treatment of obsessive-compulsive disorder (OCD), a chronic and disabling condition. However, ~40% of patients do not have a significant improvement, suggesting that new medications are needed. This study was designed to investigate the treatment response to escitalopram in OCD patients.

Methods: This open-label study involved 11 adult OCD outpatients diagnosed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders. Data were collected and the treatment response was assessed by an experienced psychiatrist by using the Yale-Brown Obsessive-Compulsive Scale. Subjects received escitalopram 30 mg/day for 12 weeks starting at 10 mg/day. Dosage adjustments were made within 2 weeks, depending on the tolerability of the patient.

Results: Six of the 11 patients (54.5%) presented a reduction of at least 40% in the baseline total Yale-Brown Obsessive-Compulsive Scale scores.

Conclusion: Despite the small sample size and the open-label nature of this trial, these data suggest that escitalopram may be a useful option for patients with OCD.

Type
Original Research
Information
CNS Spectrums , Volume 12 , Issue 7 , July 2007 , pp. 519 - 524
Copyright
Copyright © Cambridge University Press 2007

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References

REFERENCES

1.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
2.Karno, M, Golding, JM, Sorenson, SB, Burnam, MA. The epidemiology of obsessive-compulsive disorder in five US communities. Arch Gen Psychiatry. 1988;45:1094–1099.CrossRefGoogle ScholarPubMed
3.Rasmussen, SA, Eisen, JL. Epidemiology of obsessive compulsive disorder. J Clin Psychiatry. 1990;51(suppl):10–13.Google ScholarPubMed
4.Kessler, RC, Chiu, WT, Demler, O, Merikangas, KR, Walters, EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:617–627.CrossRefGoogle ScholarPubMed
5.Leon, AC, Portera, L, Weissman, MM. The social costs of anxiety disorders. Br J Psychiatry. 1995;27(suppl):19–22.CrossRefGoogle Scholar
6.Hollander, E, Stein, DJ, Kwon, JH, et al.Psychosocial function and economic costs of obsessive-compulsive disorder. CNS Spectr. 1997;2:16–25.CrossRefGoogle Scholar
7.Murray, CJ, Lopez, AD. Evidence-based health policy—lessons from the Global Burden of Disease Study. Science. 1996;274:740–743.CrossRefGoogle ScholarPubMed
8.Pallanti, S, Hollander, E, Bienstock, C, et al.Treatment non-response in OCD: methodological issues and operational definitions. Int J Neuropsychopharmacol. 2002;5:181–191.CrossRefGoogle ScholarPubMed
9.Fineberg, NA, Gale, TM. Evidence-based pharmacotherapy of obsessive-compulsive disorder. Int J Neuropsychopharmacol. 2005;8:107–129.CrossRefGoogle ScholarPubMed
10.Pallanti, S, Quercioli, L, Koran, L. Citalopram intravenous infusion in resistant obsessive-compulsive disorder: an open trial. J Clin Psychiatry. 2002;63:796–801.CrossRefGoogle ScholarPubMed
11.Ellingrod, VL. Pharmacotherapy of primary obsessive-compulsive disorder: review of the literature. Pharmacotherapy. 1998;18:936–960.CrossRefGoogle ScholarPubMed
12.Benazon, NR, Ager, J, Rosenberg, DR. Cognitive behavior therapy in treatment-naive children and adolescents with obsessive-compulsive disorder: an open trial. Behav Res Ther. 2002;40:529–539.CrossRefGoogle ScholarPubMed
13.Pediatric OCD Treatment Study Team. Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial. JAMA. 2004;292:1969–1976.CrossRefGoogle Scholar
14.Bloch, MH, Landeros-Weisenberger, A, Kelmendi, B, Coric, V, Bracken, MB, Leckman, JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry. 2006;11:622–632.CrossRefGoogle ScholarPubMed
15.Owens, MJ, Knight, DL, Nemeroff, CB. Second-generation SSRIs: human monoamine transporter binding profile of escitalopram and R-fluoxetine. Biol Psychiatry. 2001;50:345–350.CrossRefGoogle ScholarPubMed
16.Burke, WJ. Escitalopram. Expert Opin Investig Drugs. 2002;11:1477–1486.CrossRefGoogle ScholarPubMed
17.Davidson, JR, Bose, A, Wang, Q. Safety and efficacy of escitalopram in the long-term treatment of generalized anxiety disorder. J Clin Psychiatry. 2005;66:1441–1446.CrossRefGoogle ScholarPubMed
18.Stahl, SM, Gergel, I, Li, D. Escitalopram in the treatment of panic disorder: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2003;64:1322–1327.CrossRefGoogle ScholarPubMed
19.Davidson, JR. Pharmacotherapy of social anxiety disorder: what does the evidence tell us? J Clin Psychiatry. 2006;67(suppl 12):20–26.Google ScholarPubMed
20.Robert, S, Hamner, MB, Ulmer, HG, Lorberbaum, JP, Durkalski, VL. Open-label trial of escitalopram in the treatment of posttraumatic stress disorder. J Clin Psychiatry. 2006;67:1522–1526.CrossRefGoogle ScholarPubMed
21.Freeman, EW, Sondheimer, SJ, Sammel, MD, Ferdousi, T, Lin, H. A preliminary study of luteal phase versus symptom-onset dosing with escitalopram for premenstrual dysphoric disorder. J Clin Psychiatry. 2005;66:769–773.CrossRefGoogle ScholarPubMed
22.Kennedy, SH, Andersen, HF, Lam, RW. Efficacy of escitalopram in the treatment of major depressive disorder compared with conventional selective serotonin reuptake inhibitors and venlafaxine XR: a meta-analysis. J Psychiatry Neurosci. 2006;31:122–131.Google ScholarPubMed
23.First, MB, Spitzer, RL, Gibbon, M, et al.Structured Clinical Interview for DSM-IV Axis I Disorders, Patient Edition (SCID-P). version 2. New York, NY: New York State Psychiatric Institute, Biometrics Research; 1995.Google Scholar
24.Goodman, WK, Price, LH, Rasmussen, SA, et al.The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46:1006–1011.CrossRefGoogle ScholarPubMed
25.Goodman, WK, Price, LH, Rasmussen, SA, et al.The Yale-Brown Obsessive Compulsive Scale. II. Validity. Arch Gen Psychiatry. 1989;46:1012–1016.CrossRefGoogle ScholarPubMed
26.Leckman, JF, Riddle, MA, Hardin, MT, et al.The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry. 1989;28:566–573.CrossRefGoogle ScholarPubMed
27. Statistical Package for Social Sciences–SPSS for Windows. version 12.0. Chicago, III: SPSS Inc.Google Scholar
28.Schruers, K, Koning, K, Luermans, J, Haack, MJ, Griez, E. Obsessive-compulsive disorder: a critical review of therapeutic perspectives. Acta Psychiatr Scand. 2005;111:261–271.CrossRefGoogle ScholarPubMed
29.Bareggi, SR, Bianchi, L, Cavallaro, R, Gervasoni, M, Siliprandi, F, Bellodi, L. Citalopram concentrations and response in obsessive-compulsive disorder. Preliminary results. CNS Drugs. 2004;18:329–335.CrossRefGoogle ScholarPubMed
30.Montgomery, SA, Kasper, S, Stein, DJ, Bang Hedegaard, K, Lemming, OM. Citalopram 20 mg, 40 mg and 60 mg are all effective and well tolerated compared with placebo in obsessive-compulsive disorder. Int Clin Psychopharmacol. 2001;16:75–86.CrossRefGoogle ScholarPubMed
31.Mundo, E, Bianchi, L, Bellodi, L. Efficacy of fluvoxamine, paroxetine, and citalopram in the treatment of obsessive-compulsive disorder: a single-blind study. J Clin Psychopharmacol. 1997;17:267–271.CrossRefGoogle ScholarPubMed
32.Stein, DJ, Montgomery, SA, Kasper, S, Tanghoj, P. Predictors of response to pharmacotherapy with citalopram in obsessive-compulsive disorder. Int Clin Psychopharmacol. 2001;16:357–361.CrossRefGoogle ScholarPubMed
33.Fineberg, NA, Tonnoir, B, Lemming, O, Stein, DJ. Escitalopram prevents relapse of obsessive-compulsive disorder. Eur Neuropsychopharmacol. 2007;17:430–439.CrossRefGoogle ScholarPubMed
34.Stein, DJ, Andersen, EW, Tonnoir, B, Fineberg, N. Escitalopram in obsessive-compulsive disorder: a randomized, placebo-controlled, paroxetine-referenced, fixed-dose, 24-weekstudy. Curr Med Res Opin. 2007;23:701–711.CrossRefGoogle Scholar
35.Shavitt, RG, Belotto, C, Curi, M, et al.Clinical features associated with treatment response in obsessive-compulsive disorder. Compr Psychiatry. 2006;47:276–281.CrossRefGoogle ScholarPubMed
36.Rosario-Campos, MC, Leckman, JF, Mercadante, MT, et al.Adults with early-onset obsessive-compulsive disorder. Am J Psychiatry. 2001;158:1899–1903.CrossRefGoogle ScholarPubMed