scholarly journals Drug treatment of obsessive-compulsive disorder

2010 ◽  
Vol 12 (2) ◽  
pp. 187-197 ◽  
Keyword(s):  
Drug Treatment ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Options ◽  
Future Research ◽  
Considerable Proportion ◽  
Preliminary Treatment ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Rational Drug

Knowledge of pharmacotherapeutic treatment options in obsessive-compulsive disorder (OCD) has grown considerably over the past 40 years. Serotonergic antidepressants, such as selective serotonin reuptake inhibitors (SSRls) and clomipramine, are the established pharmacologic first-line treatment of OCD. Medium to large dosages and acute treatment for at least 3 months are recommended until efficacy is assessed. In case of significant improvement, maintenance treatment is necessary, Unfortunately, about half of the patients do not respond sufficiently to oral serotonergic antidepressants; augmentation with atypical antipsychotics is an established second-line drug treatment strategy. Alternatives include intravenous serotonergic antidepressants and combination with or switch to cognitive behavioral psychotherapy. Remarkably, a considerable proportion of OCD patients still do not receive rational drug treatment. Novel research approaches, such as preliminary treatment studies with glutamatergic substances, and trials with further drugs, as well as needed aspects of future research, are reviewed.

The Medical Treatment of Obsessive-Compulsive Disorder and Anxiety

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S14) ◽  
pp. 37-46 ◽  
Author(s):  
Borwin Bandelow
Keyword(s):  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
First Line ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
History Of ◽  
Higher Doses

AbstractSelective serotonin reuptake inhibitors (SSRIs) are first-line pharmacotherapy treatments for obsessive-compulsive disorder (OCD). Clomipramine is effective in OCD but associated with more adverse events. Typically, higher doses of antidepressants are required for OCD. Up to 50% of patients do not respond to initial treatment of OCD. Treatment options for nonresponders include augmentation of antidepressants with atypical antipsychotics, among other strategies. First-line treatments for anxiety disorders include SSRIs, serotonin norepinephrine reuptake inhibitors, and pregabalin. Tricyclic antidepressants are equally effective as SSRIs, but are less well tolerated. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of dependency and tolerance. Other treatment options include irreversible and reversible monoamine oxidase inhibitors, the atypical antipsychotic quetiapine, and other medications. Cognitive-behavioral therapy has been sufficiently investigated in controlled studies of OCD and anxiety disorders and is recommended alone or in combination with the above medications.

Treatment of Obsessive-Compulsive Disorder

CNS Spectrums ◽  
2007 ◽  
Vol 12 (S3) ◽  
pp. 28-35 ◽  
Author(s):  
Dan J. Stein ◽  
Jonathan C. Ipser ◽  
David S. Baldwin ◽  
Borwin Bandelow
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scale ◽  
Good Evidence ◽  
Functional Improvement ◽  
Future Research ◽  
Consensus Guidelines ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Meta Analyses

AbstractBackground: Many randomized controlled trials of the pharmacotherapy and psychotherapy of obsessive-compulsive disorder (OCD) have been undertaken. Several meta-analyses of these trials, and a number of expert consensus guidelines, have been published. This article summarizes these works, and suggests future research directions.Methods: Meta-analyses of OCD were assessed with the QUORUM statement and the Oxman and Guyatt rating scale, and consensus guidelines on the treatment of OCD were assessed with the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Current principles in the treatment of OCD, and gaps in our knowledge, were reviewed.Results: Selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy are currently viewed as the first-line treatments of choice for adult and pediatric OCD.There is also good evidence for the efficacy of atypical antipsychotics in the augmentation of patients refractory to SSRIs. Important questions remain for the field.Conclusions: There have been significant advances in both the pharmacotherapy and psychotherapy of OCD. Nevertheless, there is a paucity of longer-term trials, data on symptom remission and functional improvement, and data on treatment effectiveness in wider clinical practice. It is hoped that improved understanding of the mechanisms underlying OCD will lead to future advances.

Additive and Alternative Approaches to Treating Obsessive Compulsive Disorder

2012 ◽  
Author(s):  
Jordana Muroff ◽  
Abigail Ross ◽  
Joseph Rothfarb
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Alternative Methods ◽  
Herbal Remedies ◽  
Future Research ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Specific Alternative ◽  
Alternative Approaches ◽  
Complementary And Alternative

While cognitive-behavioral therapy (CBT) and pharmacotherapy are “gold standard” treatments for obsessive-compulsive disorder (OCD), complementary and alternative treatments are frequently sought for anxiety disorders. The purpose of this chapter is to review and discuss the available research on the application, efficacy and effectiveness of complementary and alternative methods for treating OCD. The first section identifies and reviews studies focusing on specific alternative and complementary treatments that are independent from, or work in conjunction with CBT, such as yoga, herbal remedies, motivational strategies, and bibliotherapy. The second section discusses alternative and complementary methods of more mainstream CBT and related techniques, with a particular focus on technology-supported approaches. The chapter concludes with a discussion of the methodological issues in the existing research on complementary and alternative methods in the treatment of OCD, questions for future research, and implications for providers.

scholarly journals Patient-reported outcomes in obsessive-compulsive disorder

2014 ◽  
Vol 16 (2) ◽  
pp. 239-254 ◽  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Patient Reported Outcomes ◽  
Functional Disability ◽  
Psychometric Evaluation ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Future Research ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Patient Reported

The purpose of the article was to provide an overview of patient-reported outcomes (PROs) and related measures that have been examined in the context of obsessive-compulsive disorder (OCD). The current review focused on patient-reported outcome measures (PROMs) that evaluated three broad outcome domains: functioning, health-related quality of life (HRQoL), and OCD-related symptoms. The present review ultimately included a total of 155 unique articles and 22 PROMs. An examination of the PROs revealed that OCD patients tend to suffer from significant functional disability, and report lower HRQoL than controls. OCD patients report greater symptom severity than patients with other mental disorders and evidence indicates that PROMs are sensitive to change and may be even better than clinician-rated measures at predicting treatment outcomes. Nonetheless, it should be noted that the measures reviewed lacked patient input in their development. Future research on PROMs must involve patient perspectives and include rigorous psychometric evaluation of these measures.

scholarly journals A Qualitative Study Exploring Neurodiversity Conference Themes, Representations and Evidence-Based Justifications for the Explicit Inclusion and Valuing of OCD

2021 ◽  
Vol 5 (2) ◽  
pp. 111-138
Author(s):  
Damian Mellifont
Keyword(s):  
Qualitative Study ◽  
Obsessive Compulsive Disorder ◽  
Google Scholar ◽  
Future Research ◽  
Evidence Based ◽  
Exploratory Research ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

The inclusivity of neurodiversity conferences is a new field of research. Utilising Obsessive Compulsive Disorder (OCD) as an example, this study aims to critically investigate issues of inclusivity in the flyers advertising these conferences. This exploratory research is informed by 22 conference flyers and 14 scholarly articles retrieved from respective internet and Google Scholar enquiries. These articles offered evidence-based justifications for a greater inclusion of OCD-focused content in neurodiversity conferences. The study cautions that the lack of explicit inclusion of OCD as a topic among conferences can be harmful to persons who identify with this particular type of neurodivergence. This study offers a sound base from which future research focusing upon other forms of neurodivergence and issues of neurodiversity conference inclusivity and intersectionality can develop.

Role of serotonin in obsessive-compulsive disorder

1998 ◽  
Vol 173 (S35) ◽  
pp. 13-20 ◽  
Author(s):  
H. G. Baumgarten ◽  
Z. Grozdanovic
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Expression Patterns ◽  
Term Treatment ◽  
Continuous Treatment ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Long Term Treatment ◽  
Pre Treatment

Background Serotonin may play a role in the pathophysiology of obsessive-compulsive disorder (OCD) because of the anti-obsessional effect of selective serotonin reuptake inhibitors (SSRJs).Method The literature is reviewed on knowledge of the role of serotonergic neurons in brain function, studies on monoamine metabolites in cerebrospinal fluid (CSF), various stress neuropeptides, neuroendocrine and behavioural challenge after administration of direct and indirect serotomimetic compounds, and neuroanatomical data on brain circuits organising behaviour.Results In most of the OCD cases analysed, CSF 5-hydroxyindoleacetic acid and homovanillic acid concentrations do not significantly differ from age-corrected controls. However, a relationship appears to exist between pre-treatment levels of these metabolites and clinical response to drugs acting on the serotonin transporter. Abnormalities in CSF arginine vasopressin, corticotropin-releasing hormone, oxytocin and somatostatin levels have been reported in OCD. Long-term treatment with high-doses of clomipramine, fluvoxamine, and fluoxetine tend to correct these neuropeptide abnormalities.Conclusions We hypothesise that continuous treatment with SSRJs alters serotonin turnover and neuropeptide expression patterns in OCD-entertaining functional forebrain/midbrain circuits.

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