The Pharmacological Treatment of Obsessive-Compulsive Disorder

Psychiatr Clin North Am. 2023 Mar;46(1):107-119. doi: 10.1016/j.psc.2022.11.005. Epub 2023 Jan 4.

Abstract

Pharmacological treatment is a mainstay of the care of individuals with obsessive-compulsive disorder. Robust evidence supports the use of the selective serotonin reuptake inhibitors and the older tricyclic drug clomipramine. Other antidepressants are less effective (or have been insufficiently studied). When first-line treatment with these agents, and with appropriate psychotherapy, is ineffective, several augmentation strategies are available, though their evidentiary support is weaker. A substantial minority of patients have persistent symptoms despite optimal evidence-based treatment. Further work and more treatment options are needed.

Keywords: Clomipramine; Glutamate; Neuroleptic; Obsessive-compulsive disorder (OCD); Pharmacotherapy; Selective serotonin reuptake inhibitor (SSRI).

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Clomipramine / therapeutic use
  • Humans
  • Obsessive-Compulsive Disorder* / drug therapy
  • Psychotherapy
  • Selective Serotonin Reuptake Inhibitors / therapeutic use

Substances

  • Clomipramine
  • Selective Serotonin Reuptake Inhibitors
  • Antidepressive Agents