Current trends in drug treatment of obsessive–compulsive disorder

Figures & data

Table 1 Summary of meta-analyses of clomipramine and selective serotonin reuptake inhibitors in OCD

Study	n	Design (number of trials)	Duration	Effect on OCD
Greist et al^Citation75	1520	PL-controlled (7) [CMI, FLX, FLV, SER]	10–13 weeks	CMI and SSRIs >PL CMI >SSRIs No significant difference in drop-outs because of adverse effects
Piccinelli et al^Citation76	1809	PL-controlled (26) [CMI, FLX, FLV, SER, TCA]	5–36 weeks	CMI and SSRIs >PL CMI >SSRIs
Stein et al^Citation77	1039	PL-controlled (12) [FLX, FLV, SER, TRZ, CMI] Head-to-head (10) Open trial (6)	6–13 weeks	CMI and SSRIs >PL CMI = SER >FLX
Abramowitz^Citation78	20 studies with a range of 10–519 participants in each study	PL-controlled (5) [FLX, FLV, SER, CMI] Head-to-head (4)	4–13 weeks	CMI and SSRIs >PL CMI >FLV >FLX >SER Adverse effects correlated with effect size
Kobak et al^Citation79	4641	PL-controlled (5) [FLX, FLV, SER, CMI, PAR] Head-to-head (7)	Not reported	CMI and SSRIs >PL CMI = FLV = FLX other SSRIs No difference in drop-out rates
Ackerman et al^Citation80	1876	PL-controlled (18) [CMI, FLX, FLV, SER, PAR] Head-to-head (8)	8–13 weeks	CMI and SSRIs >PL CMI = FLV = FLX = PAR
Soomro^Citation21	3097	PL-controlled (17) [FLX, FLV, SER, PAR, CIT]	6–13 weeks	Overall RR 1.84 (95% CI 1.56–2.17) Citalopram RR 1.58 (95% CI 1.20–2.08) Fluoxetine RR 2.41 (95% CI 1.58–4.56) Paroxetine RR 1.74 (95% CI 1.28–2.36) Sertraline RR 1.54 (95% CI 1.20–1.99) NNT 6–12

Abbreviations: CMI, clomipramine, FLX, fluoxetine; FLV, fluvoxamine; SER, sertraline; TRZ, trazodone; TCA, tricyclic antidepressants; PAR, paroxetine; CIT, citalopram, PL, placebo; SSRI, selective serotonin reuptake inhibitor; RR, relative risk; NNT, number-needed-to-treat, OCD, obsessive-compulsive disorder.

GreistJHJeffersonJWKobakKAKatzelnickDJSerlinRCEfficacy and tolerability of serotonin transport inhibitors in obsessive- compulsive disorder. A meta-analysisArch Gen Psychiatry199552153607811162

 PubMed Web of Science ®Google Scholar

PiccinelliMPiniSBellantuonoCWilkinsonGEfficacy of drug treatment in obsessive-compulsive disorder. A meta-analytic reviewBr J Psychiatry199516644244437795913

 PubMed Web of Science ®Google Scholar

SteinDJSpadacciniEHollanderEMeta-analysis of pharmacotherapy trials for obsessive-compulsive disorderInt Clin Psychopharmacol199510111187622800

 PubMed Web of Science ®Google Scholar

AbramowitzJSEffectiveness of psychological and pharmacological treatments for obsessive-compulsive disorder: A quantitative reviewJ Consult Clin Psychol199765144529103733

 PubMed Web of Science ®Google Scholar

KobakKAGreistJHJeffersonJWKatzelnickDJHenkHJBehavioral versus pharmacological treatments of obsessive compulsive disorder: A meta-analysisPsychopharmacology (Berl)199813632052169566805

 PubMed Web of Science ®Google Scholar

AckermanDLGreenlandSMultivariate meta-analysis of controlled drug studies for obsessive-compulsive disorderJ Clin Psychopharmacol200222330931712006902

 PubMed Web of Science ®Google Scholar

SoomroGMAltmanDRajagopalSOakley-BrowneMSelective serotonin re-uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD)Cochrane Database Syst Rev2008231CD00176518253995

 PubMed Web of Science ®Google Scholar