Long-term sertraline treatment of obsessive compulsive disorder: a 52-week double-blind comparative study versus placebo

Deep brain stimulation (DBS) is currently under research for the treatment of psychiatric disorders, e.g., obsessive-compulsive disorder (OCD) and treatment-resistant depression (TRD). Since the application of DBS in psychiatry has been in use for about 20 years, it is necessary to evaluate its long-term use now. A main issue in the long-term treatment of DBS concerns the effects of a discontinuation of stimulation due to intended as well as unintended reasons. In this contribution, the literature describing discontinuation effects following DBS in OCD and TRD is reviewed. Furthermore, a patient is reported in depth who experienced an unintended discontinuation of supero-lateral medial forebrain bundle (slMFB) DBS for TRD. In this case, the battery was fully depleted without the patient noticing. DBS had led to a sustained response for seven years before discontinuation of stimulation for just several weeks caused a progressive worsening of depression. Altogether, the rapid occurrence of symptom worsening, the absence of a notification about the stimulation status and the difficulties to recapture antidepressant response represent important safety aspects. For a further understanding of the described effects, time courses until worsening of depression as well as biological mechanisms need to be investigated in double-blind controlled trials.

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Faculty Opinions recommendation of Lamotrigine augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder: a double-blind, placebo-controlled study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.715498009.791052959 ◽

2012 ◽

Author(s):

Evelyn Stewart ◽

Annie J Kuan

Keyword(s):

Obsessive Compulsive Disorder ◽

Serotonin Reuptake ◽

Serotonin Reuptake Inhibitors ◽

Controlled Study ◽

Treatment Resistant ◽

Obsessive Compulsive ◽

Double Blind ◽

Double Blind Placebo ◽

Compulsive Disorder

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Faculty Opinions recommendation of Granisetron adjunct to fluvoxamine for moderate to severe obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718508464.793497757 ◽

2014 ◽

Author(s):

Eric Hollander

Keyword(s):

Obsessive Compulsive Disorder ◽

Controlled Trial ◽

Obsessive Compulsive ◽

Double Blind ◽

Double Blind Placebo ◽

Compulsive Disorder

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Faculty Opinions recommendation of A double-blind, placebo-controlled study of risperidone addition in serotonin reuptake inhibitor-refractory obsessive-compulsive disorder.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718508456.793497749 ◽

2014 ◽

Author(s):

Eric Hollander

Keyword(s):

Obsessive Compulsive Disorder ◽

Reuptake Inhibitor ◽

Serotonin Reuptake ◽

Controlled Study ◽

Serotonin Reuptake Inhibitor ◽

Obsessive Compulsive ◽

Double Blind ◽

Double Blind Placebo ◽

Compulsive Disorder

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Augmentation strategy with olanzapine in resistant obsessive compulsive disorder: an Italian long-term open-label study

Journal of Psychopharmacology ◽

10.1177/0269881105053299 ◽

2005 ◽

Vol 19 (4) ◽

pp. 392-394 ◽

Cited By ~ 34

Author(s):

Donatella Marazziti ◽

Chiara Pfanner ◽

Bernardo Dell’osso ◽

Antonio Ciapparelli ◽

Silvio Presta ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Obsessive Compulsive ◽

Open Label ◽

Open Label Study ◽

Label Study ◽

Compulsive Disorder ◽

Augmentation Strategy

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Duloxetine augmentation in resistant obsessive compulsive disorder: Surveying a new medication for challenges in treatment of OCD

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.361 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S415-S415

Author(s):

A. Mowla

Keyword(s):

Obsessive Compulsive Disorder ◽

Primary Outcome Measure ◽

Controlled Clinical Trial ◽

Double Blind Study ◽

Obsessive Compulsive ◽

Double Blind ◽

Compulsive Disorder ◽

Significant Difference ◽

Competing Interest ◽

To Receive

IntroductionUp to 50% of patients with OCD have failed to respond in SSRI trials, so looking for pharmacological alternatives in treatment of obsessive compulsive disorder (OCD) seems necessary.ObjectivesSurveying duloxetine augmentation in treatment of resistant OCD.AimsStudy the effects of serotonin-norepinephrine enhancers for treatment of OCD.MethodsThis augmentation trial was designed as an 8-week randomized controlled, double blind study. Forty-six patients suffering from OCD who had failed to respond to at least 12 weeks of treatment with a selective serotonin reuptake inhibitor (fluoxetine, citalopram or fluvoxamine) were randomly allocated to receive duloxetine or sertraline plus their current anti OCD treatment. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure.ResultsForty-six patients (24 of 30 in duloxetine group and 22 of 27 in sertraline group) completed the trial. Both groups showed improvement over the 8-week study period (mean Y-BOCS total score at week 8 as compared with baseline: P < 0.001 and P < 0.001) without significant difference (P = 0.861). Those receiving duloxetine plus their initial medications experienced a mean decrease of 33.0% in Y-BOCS score and the patients with sertraline added to their initial medication experienced a mean decrease of 34.5% in Y-BOCS.ConclusionsOur double blind controlled clinical trial showed duloxetine to be as effective as sertraline in reducing obsessive and compulsive symptoms in resistant OCD patients. However, it needs to be noted that our study is preliminary and larger double blind placebo controlled studies are necessary to confirm the results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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