Pharmacotherapy in body dysmorphic disorder: relapse prevention and novel treatments

ABSTRACT

Introduction: Body dysmorphic disorder is a debilitating disorder that often presents with significant delusionality, low insight, and both medical and psychiatric comorbidities, presenting a challenge for treatment and long-term management. Its typically chronic course requires that therapy be continued indefinitely, but only a few studies of long-term pharmacotherapeutic management exist.

Areas covered: The authors discuss the current understanding of body dysmorphic disorder, focusing specifically on: epidemiology, clinical presentation, challenges in treatment, treatment options, and the importance of the further study of the long-term management of the disorder.

Expert opinion: Serotonin reuptake inhibitors are the established drug of choice in patients with body dysmorphic disorder. Initial studies suggest that other agents such as augmentation antipsychotic medication may also be of use in combination with serotonin reuptake inhibitors, but there is a lack of studies comparing new treatments to serotonin reuptake inhibitors. Due to the chronic nature of body dysmorphic disorder, further research is needed to clarify the role of pharmacotherapy in long-term management and relapse prevention. Future studies should explore the long-term use of therapies and combinations of different therapeutics with the goal of effectively managing this debilitating, chronic condition.

KEYWORDS:

• SSRI
• SRI
• antidepressants
• body dysmorphic disorder
• BDD
• obsessive compulsive disorder
• OCD
• obsessive compulsive-related disorder
• OCRD

Article Highlights

• Body dysmorphic disorder (BDD) is a relatively common chronic disease that requires long-term management.

• The current treatment for BDD is a serotonin reuptake inhibitor (SRI) but the exact mechanism of its action in regard to neurobiology of BDD is not clearly identified.

• More pharmacotherapy options are needed for treatment of BDD in individuals who do not respond to or develop side effects to SRIs.

• More research is still needed to identify additional therapies to treat BDD.

• Relapse is common in the treatment of BDD, so long-term management is necessary. Further research is needed to address long-term maintenance therapy and relapse prevention.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript has not been funded.