The comparative effectiveness of treatments for obsessive-compulsive disorder

Journal/Book: Bull Menninger Clin. 1998; 62: Box 829, Topeka, KS 66601. Menninger Foundation. A65-A81.

Abstract: With the exception of neurosurgery, treatments for obsessive-compulsive disorder were largely ineffective until 1996. That year, clomipramine became available and the first article describing modern behavior therapy was published. Potent serotonin reuptake inhibitors and behavior therapy involving exposure and ritual prevention have been established as the cornerstones of effective treatment for obsessive-compulsive disorder. Methods for optimizing effectiveness of these two main modalities are move widely recognized, although overdosing may hamper effective pharmacotherapy. The comparative efficacies of pharmacotherapy and behavior therapy remain in dispute, although all meta-analyses have identified behavior therapy as more effective both in terms of magnitude of improvement short term and lasting gains long term. Finally, neurosurgery still merits consideration for the tiny minority of patients who are incapacitated by OCD and unresponsive to serotonin reuptake inhibitors and behavior therapy.

Note: Article Greist JH, Healthcare Technol Syst, 2711 Allen Blvd, POB 628365, Middleton,WI 53562 USA

Keyword(s): CLOMIPRAMINE-TREATED PATIENTS; TERM FOLLOW-UP; DOUBLE-BLIND; BEHAVIOR-THERAPY; ADJUVANT BUSPIRONE; COGNITIVE THERAPY; CONTROLLED TRIAL; FLUVOXAMINE; FLUOXETINE; VENLAFAXINE

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