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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.
AuthorsC J McDougle, W K Goodman, L H Price
JournalPharmacopsychiatry (Pharmacopsychiatry) Vol. 26 Suppl 1 Pg. 24-9 (May 1993) ISSN: 0176-3679 [Print] GERMANY
PMID8378419 (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)
  • Serotonin Uptake Inhibitors (therapeutic use)
  • Sertraline

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