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 .
Fluvoxamine versus clomipramine for obsessive-compulsive disorder: a double-blind comparison.
The efficacy and tolerability of fluvoxamine ( 100 - 300 mg/day ) and clomipramine ( 100 - 250 mg/day ) were compared in a r and omized , double-blind , parallel-group study of 79 patients with obsessive-compulsive disorder ( OCD ) without coexisting major depression . After a 2-week placebo lead-in period , patients were r and omized to fluvoxamine ( 37 patients ) or clomipramine ( 42 patients ) for 10 weeks . Efficacy was evaluated with the Yale-Brown Obsessive-Compulsive Scale ( Y-BOCS ) , the National Institute of Mental Health Obsessive-Compulsive scale , and Patient and Clinical Global Improvement scales . Hamilton Rating Scale for Depression scores and somatic symptoms were also assessed . Seventy-eight percent of fluvoxamine patients and 64 % of clomipramine patients completed the study . At the end of treatment , 56 % of fluvoxamine patients were classified as responders ( > or = 25 % decrease in Y-BOCS score ) , compared with 54 % of clomipramine patients . Both groups showed steady improvement throughout the study ; no statistically significant differences were observed between the groups for any efficacy variable at any time . A similar percentage of patients in both groups withdrew because of adverse events . No serious adverse events related to drug occurred with either drug . Insomnia , nervousness , and dyspepsia were more statistically frequent with fluvoxamine ; dry mouth and postural hypotension were more frequent with clomipramine . In this study , fluvoxamine and clomipramine were equally effective in reducing OCD symptoms over a 10-week treatment period but displayed different side effect profiles
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 .