The comparative effectiveness of treatments
for obsessive-compulsive disorder
by
Greist JH
Madison Institute of Medicine, Wisconsin, USA.
Bull Menninger Clin 1998 Fall; 62(4 Suppl A): A65-81

ABSTRACT

With the exception of neurosurgery, treatments for obsessive-compulsive disorder were largely ineffective until 1996. That year, clomipramine became available and the first article describing modern behavior therapy was published. Potent serotonin reuptake inhibitors and behavior therapy involving exposure and ritual prevention have been established as the cornerstones of effective treatment for obsessive-compulsive disorder. Methods for optimizing effectiveness of these two main modalities are more widely recognized, although overdosing may hamper effective pharmacotherapy. The comparative efficacies of pharmacotherapy and behavior therapy remain in dispute, although all meta-analyses have identified behavior therapy as more effective both in terms of magnitude of improvement short term and lasting gains long term. Finally, neurosurgery still merits consideration for the tiny minority of patients who are incapacitated by OCD and unresponsive to serotonin reuptake inhibitors and behavior therapy.

OCD
SSRIs
Sertraline
Fluoxetine
Citalopram
Paroxetine
Fluvoxamine
Clomipramine
SSRI interactions
SSRIs and jealousy
Dopaminergics and OCD

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