The pharmacotherapy of obsessive-compulsive disorder.

Abstract

Potent inhibitors of 5-hydroxytryptamine (5-HT) reuptake have clearly been established as the first-line pharmacotherapy for treatment of obsessive-compulsive disorder (OCD). Although a variety of tricyclic antidepressants and monoamine oxidase inhibitors have similar efficacy in the treatment of depression and panic disorder, potent blockade of 5-HT transport appears to be a prerequisite for effective treatment of OCD. Adding agents that enhance 5-HT neurotransmission to ongoing treatment in patients whose OCD is refractory to 5-HT reuptake inhibitors has not yielded impressive results. However, the addition of low-dose dopamine (DA) antagonists to the regimens of treatment-resistant patients appears to be a potentially useful strategy for the specific subgroup of OCD patients with a comorbid chronic tic disorder such as Tourette's syndrome. Because of the toxicity associated with neuroleptics, a time-limited trial of those agents, with reassessment at regular intervals, is indicated. Pharmacologic studies suggest that both the 5-HT and DA systems may be critical to the treatment and possibly the pathophysiology of OCD.

• Authors: C J McDougle, W K Goodman, L H Price
• Journal: Pharmacopsychiatry (Pharmacopsychiatry) Vol. 26 Suppl 1 Pg. 24-9 (May 1993) ISSN: 0176-3679 [Print] Germany
• PMID: 8378419 (Publication Type: Journal Article, Review)

Chemical References

• Serotonin Uptake Inhibitors
• Fluoxetine
• 1-Naphthylamine
• Clomipramine
• Fluvoxamine
• Sertraline
• Desipramine
• Buspirone

Topics

• 1-Naphthylamine (analogs & derivatives, therapeutic use)
• Buspirone (therapeutic use)
• Clomipramine (therapeutic use)
• Desipramine (therapeutic use)
• Fluoxetine (therapeutic use)
• Fluvoxamine (therapeutic use)
• Humans
• Obsessive-Compulsive Disorder (drug therapy)
• Selective Serotonin Reuptake Inhibitors (therapeutic use)
• Sertraline