Psychiatry Research EG

What are the latest psychotherapeutic and pharmacotherapeutic treatment recommendations for obsessive-compulsive disorder (OCD)? OCD is a relatively common disorder with a lifetime prevalence of ∼2% in the general population. It often has an early onset usually in childhood or adolescence and frequently becomes chronic and disabling if left untreated. High associated healthcare utilization and costs and reduced productivity resulting in loss of earning pose a huge economic burden to OCD patients and their families employers and society. OCD is characterized by the presence of obsessions and compulsions that are time-consuming cause marked distress or significantly interfere with a persons functioning. Most patients with OCD experience symptoms throughout their lives and benefit from long-term treatment. Both psychotherapy and pharmacotherapy are recommended either alone or in combination for the treatment of OCD. Cognitive-behavioral therapy is the psychotherapy of choice. Pharmacologic treatment options include the tricyclic antidepressant clomipramine and the selective serotonin reuptake inhibitors (SSRIs) citalopram fluoxetine fluvoxamine paroxetine and sertraline. These have all shown benefit in acute treatment trials clomipramine fluvoxamine fluoxetine and sertraline have also demonstrated benefit in long-term treatment trials (at least 24 weeks) and clomipramine sertraline and fluvoxamine have United States Food and Drug Administration approvals for use in children and adolescents. Available treatment guidelines recommend first-line use of an SSRI (ie fluoxetine fluvoxamine paroxetine sertraline or citalopram) in preference to clomipramine due to the latters less favorable adverse-event profile. Further pharmacotherapy for a minimum of 1-2 years is recommended before very gradual withdrawal may be considered. (PsycINFO Database Record (c) 2010 APA all rights reserved)