Abstract | INTRODUCTION: OBJECTIVE: To test these hypotheses, we conducted a randomized, double-blind, double-dummy study of pulse-loaded intravenous versus oral CMI, followed by open-label oral CMI for 12 weeks. METHODS: We enrolled a volunteer and referred group of 34 adults with a primary diagnosis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition obsessive-compulsive disorder of > or =1-year duration and Yale-Brown Obsessive Scale score of > or =20. Eligible subjects had failed > or =2 adequate serotonin reuptake inhibitor trials. Subjects received pulse loaded CMI 150 mg by vein or by mouth on day 1 and 200 mg on day 2. Oral CMI began on day 6 at 200 mg/d and was increased by 25 mg every 4 days to 250 mg/d, as tolerated, for 12 weeks. RESULTS: Adverse events led to one withdrawal during oral pulse loading and 5 during open-label oral treatment. Intravenous pulse loading did not induce a more rapid or greater Yale-Brown Obsessive Scale score decrease than oral pulse loading at day 6 or by week 12. Day 6 and week 12 improvement were unrelated to plasma drug or metabolite concentrations. Pulse loading itself seemed to induce more rapid and greater improvement than expected in treatment-resistant obsessive-compulsive disorder. CONCLUSIONS:
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Authors | Lorrin M Koran, Elias Aboujaoude, Herbert Ward, Nathan A Shapira, Floyd R Sallee, Nona Gamel, Michael Elliott |
Journal | Journal of clinical psychopharmacology
(J Clin Psychopharmacol)
Vol. 26
Issue 1
Pg. 79-83
(Feb 2006)
ISSN: 0271-0749 [Print] United States |
PMID | 16415712
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
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Chemical References |
- Serotonin Uptake Inhibitors
- Clomipramine
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Topics |
- Administration, Oral
- Adolescent
- Adult
- Clomipramine
(administration & dosage, therapeutic use)
- Drug Administration Schedule
- Humans
- Infusions, Intravenous
- Middle Aged
- Obsessive-Compulsive Disorder
(drug therapy)
- Selective Serotonin Reuptake Inhibitors
(administration & dosage, therapeutic use)
- Time Factors
- Treatment Failure
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