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 .
Serotonin Transporter Imaging with [123I]β-CIT SPECT before and after One Year of Citalopram Treatment of Obsessive-Compulsive Disorder
Background : Two thirds of patients with obsessive-compulsive disorder ( OCD ) respond to treatment with selective serotonin reuptake inhibitors ( SSRIs ) . The neurobiological mechanisms of SSRI action and failure to respond to SSRI treatment remain to be eluci date d. Objectives : The aim of this pilot study was to quantify changes in the availability of serotonin transporter ( SERT ) in the course of SSRI treatment and to relate these changes to improvements of clinical symptoms . Methods : Ten patients with OCD were investigated at baseline and 5 of them after 1 year of SSRI treatment with citalopram 60 mg per day using brain single photon emission computed tomography and [123I]β-CIT .  Specific-to-nondisplaceable [123I]β-CIT binding ratios ( V3″ ) were calculated in SERT-rich brainstem , midbrain and thalamus using a magnetic resonance imaging-based region of interest ( ROI ) analysis . Symptom severity was evaluated with the Yale-Brown Obsessive-Compulsive Scale ( Y-BOCS ) . Results : V3″ differed significantly between pretreatment and follow-up scans in all three brain regions , thalamus , midbrain as well as in brainstem . In thalamic ROI , differ ences in SERT availability and Y-BOCS ratings correlated . In midbrain , a trend toward a significant association was found . In brainstem , no relationship was revealed . Conclusions : Higher occupancy of SERT by citalopram seems to be associated with better clinical response after 1 year of SSRI treatment of patients with OCD
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 .