The Medical Treatment of Obsessive-Compulsive Disorder and Anxiety

  title={The Medical Treatment of Obsessive-Compulsive Disorder and Anxiety},
  author={Borwin Bandelow},
  journal={CNS Spectrums},
  pages={37 - 46}
  • B. Bandelow
  • Published 1 September 2008
  • Psychology, Medicine
  • CNS Spectrums
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… 
An update on the pharmacological treatment of anxiety and related disorders
  • K. Outhoff
  • Psychology, Medicine
    South African Family Practice
  • 2016
The pharmacology of these anxiolytic drugs is described and updated evidence for their use in the anxiety and related disorders is provided.
Lamotrigine Augmentation Versus Placebo in Serotonin Reuptake Inhibitors-Resistant Obsessive-Compulsive Disorder: A Randomized Controlled Trial
Evidence is provided that this augmentation of lamotrigine is well tolerated and may be an effective strategy for patients with refractory obsessive-compulsive disorder.
Antipsychotic Augmentation of Serotonin Reuptake Inhibitors in Treatment-Resistant Obsessive-Compulsive Disorder: An Update Meta-Analysis of Double-Blind, Randomized, Placebo-Controlled Trials
Antipsychotics were superior to placebo in treating obsessions, compulsions, and achieving response and antipsychotic augmentation of serotonin reuptake inhibitors can be regarded as an evidence-based measure in treatment-resistant obsessive-compulsive disorder.
N-Acetyl Cysteine in the Treatment of Obsessive Compulsive and Related Disorders: A Systematic Review
  • G. Oliver, O. Dean, J. Sarris
  • Medicine, Psychology
    Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology
  • 2015
Overall, NAC demonstrates activity in reducing the severity of symptoms, with a good tolerability profile and minimal adverse effects, and encouraging results have been demonstrated from the few pilot studies that have been conducted.
A Comparative Study of Aripiprazole, Olanzapine, and L-Methylfolate Augmentation in Treatment Resistant Obsessive-Compulsive Disorder
Augmentation of SRIs with olanzapine or aripiprazole with L-methyl folate could be a promising option for resistant OCD.
Generalized Anxiety Disorder in Adults: Focus on Pregabalin
Pregabalin is a novel structural analogue of the inhibitory neurotransmitter GABA, acting to reduce calcium ion flow through the α2δ subunit of pre-synaptic voltage-dependent calcium channels, which has low abuse potential.
Development and Psychometric Evaluation of the Treatment-Emergent Activation and Suicidality Assessment Profile
Through further evaluation of the TE-ASAP in the context of a controlled multimodal trial in youth with obsessive–compulsive disorder, it is hoped to augment understanding of activation syndrome and, in turn, mitigate risks through early detection of this potentially lifethreatening adverse effect.
Participant Characteristics as Modifiers of Response to N-Acetyl Cysteine (NAC) in Obsessive-Compulsive Disorder
We previously reported on a 16-week, double-blind, randomized placebo-controlled trial (RCT) using 3 grams per day of N-acetyl cysteine (NAC) (1.5 grams twice per day) in 44 participants (aged 18–70)


A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder
Antipsychotic augmentation in SRI-refractory OCD is indicated in patients who have been treated for at least 3 months of maximal-tolerated therapy of an SRI, and evidence regarding the efficacy of quetiapine and olanzapine is inconclusive.
On the Pharmacotherapy of Obsessive—Compulsive Disorder: Is a Consensus Possible?
The available research evidence suggests that clomipramine possesses greater antiobsessional efficacy than do the SSRIs, and may be used as first-line treatments for OCD when properly used in small initial doses with gradual increases.
Adjunctive quetiapine for serotonin reuptake inhibitor-resistant obsessive–compulsive disorder: a meta-analysis of randomized controlled treatment trials
A meta-analysis of existing double-blind randomized placebo-controlled studies looking at the addition of the second-generation antipsychotic quetiapine in patients with obsessive–compulsive disorder showed evidence of efficacy for adjunctive quetuapine on the primary efficacy criterion, but the clinical significance was limited by between-study heterogeneity.
Clomipramine, Clonazepam, and Clonidine Treatment of Obsessive‐Compulsive Disorder
The results confirm the efficacy of clomipramine in the treatment of OCD and suggest that clonazepam might be a useful alternative treatment for patients with this disorder.
Efficacy of Drug Treatment in Obsessive–Compulsive Disorder: a Meta-Analytic Review
Antidepressant drugs are effective in the short-term treatment of patients suffering from OCD; although the increase in improvement rate over placebo was greater for clomipramine than for SSRIs, direct comparison between these drugs showed that they had similar therapeutic efficacy on obsessive–compulsive symptoms.
A Double Blind Comparison of Venlafaxine and Paroxetine in Obsessive-Compulsive Disorder
Results show that venlafaxine was equally effective to paroxetine in treating patients with OCD, and may be a useful therapy for obsessive-compulsive patients, but is not superior to SSRIs.
Paroxetine versus Clomipramine in the Treatment of Obsessive–Compulsive Disorder
Paroxetine is as effective as clomipramine in the treatment of OCD and the comparable efficacy and better tolerability of parxetine suggest that it would be an appropriate treatment for OCD.
Combining Pharmacotherapy with Cognitive‐Behavioral Interventions for Obsessive‐Compulsive Disorder
The state of the art is presented with reference to the consensual recommendations proposed in the last 10 years for obsessive‐compulsive disorder, and the importance of joint efforts of psychological and biological teams to develop new treatments is stressed.
A multicenter investigation of fixed-dose fluoxetine in the treatment of obsessive-compulsive disorder.
Fluoxetine was associated with a statistically significant reduction in OCD severity, including time engaged in obsessional and/or compulsive behaviors, and greater efficacy at 60 mg/d was observed.