CONCLUSIONS The effects of treatment with clomipramine and selective serotonin reuptake inhibitors ( SSRIs : fluvoxamine , sertraline , fluoxetine , citalopram , and escitalopram ) proved to be similar , except for the lower adherence rate in case of clomipramine because of its side effects .
PURPOSE This systematic review examines the efficacy of pharmacological therapy for obsessive-compulsive disorder ( OCD ) , addressing two major issues : which treatment is most effective in treating the patient 's symptoms and which is beneficial for maintaining remission .
Sertraline and Fluoxetine Treatment of Obsessive-Compulsive Disorder: Results of a Double-Blind, 6-Month Treatment Study
The purpose of this study was to evaluate the comparative efficacy and tolerability of sertraline and fluoxetine in the treatment of obsessivecompulsive disorder ( OCD ) . Out patients meeting DSM-IV criteria for OCD , with a Yale-Brown Obsessive-Compulsive ( Y-BOCS ) total score ≥ 17 , an NIMH Global Obsessive-Compulsive ( NIMH-OC ) scale score ≥ 7 , and a CGI-Severity score ≥ 4 were r and omized to 24 weeks of double-blind treatment with sertraline ( N = 77 ) or fluoxetine ( N = 73 ) . Primary efficacy measures consisted of the Y-BOCS , the NIMH-OC scale , and the CGI-Severity ( CGI-S ) and Improvement ( CGI-I ) scales . Equivalent and significant ( p < 0.001 ) improvement was found at week 24 in Y-BOCS and NIMH-OC scale scores  for sertraline and fluoxetine . After 12 weeks , 49.2 % of patients on sertraline were rated on the CGI-S scale as being mildly ill or not ill compared to 24.6 % on fluoxetine ( p < 0.01 ) . A Cox analysis found patients on sertraline to have a statistically nonsignificant 42 % greater likelihood of achieving a response by week 12 ( CGI-I , much or very much improved ; 95 % CI , 0.85 , 2.38;p = 0.18 ) . Sertraline treatment also result ed in a higher proportion of remissions  than fluoxetine ( defined as a CGI-I ≤ 2 and a Y-BOCS score ≤ 11 ) , both at week 12 ( 20 % vs. 8 % ; χ2 , 3.95;df 1;p = 0.047 ) and week 24 ( 36 % vs. 22 % ; χ2 , 3.18;df , 1;p = 0.075 ) . Both medications were welltolerated and demonstrated significant efficacy in the treatment of out patients with moderate to severe OCD with the subjects treated with sertraline showing a greater likelihood of remission as well as an earlier improvement on some but not all efficacy
CONCLUSIONS The effects of treatment with clomipramine and selective serotonin reuptake inhibitors ( SSRIs : fluvoxamine , sertraline , fluoxetine , citalopram , and escitalopram ) proved to be similar , except for the lower adherence rate in case of clomipramine because of its side effects .
PURPOSE This systematic review examines the efficacy of pharmacological therapy for obsessive-compulsive disorder ( OCD ) , addressing two major issues : which treatment is most effective in treating the patient 's symptoms and which is beneficial for maintaining remission .