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  • Title: On the pharmacotherapy of obsessive-compulsive disorder: is a consensus possible?
    Author: Todorov C, Freeston MH, Borgeat F.
    Journal: Can J Psychiatry; 2000 Apr; 45(3):257-62. PubMed ID: 10779882.
    Abstract:
    OBJECTIVE: To examine the efficacy and tolerability of clomipramine compared with the selective serotonin reuptake inhibitors (SSRIs) in the treatment of obsessive-compulsive disorder (OCD), bearing in mind the recent Expert Consensus Guidelines recommendation to use clomipramine after 2 to 3 failed SSRI trials. METHOD: The literature on the pharmacotherapy of OCD was critically examined. RESULTS: The available research evidence is not conclusive but suggests that clomipramine possesses greater anti-obsessional efficacy than do the SSRIs. In addition, when clomipramine is presented to patients in a positive way, and properly used in small initial doses with gradual increases, it seems to be tolerated as well as the SSRIs. CONCLUSION: Recently expressed opinions that clomipramine should be used to treat OCD after 2 to 3 failed SSRI trials are not supported by research evidence. Both clomipramine and the SSRIs may be used as first-line treatments for OCD.
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