Pharmacotherapy for obsessive‐compulsive disorder
Abstract
Pharmacotherapeutic options for obsessive-compulsive disorder (OCD) have expanded over the past half-century since medications were first found to be effective for the treatment of OCD. Currently, the serotonin reuptake inhibitors (SRIs) represent the first-line pharmacotherapy for OCD. High dosages and long trials of the SRIs are needed for adequate treatment of OCD. The use of SRIs for the treatment of OCD is reviewed, then other pharmacotherapeutic treatment options, including SRI augmentation and alternative monotherapies, are discussed. The preponderance of data demonstrates that SRI augmentation with neuroleptics is efficacious for treatment-refractory OCD. There is substantially less evidence supporting other alternative strategies. Finally, neurosurgical and device-based approaches for treatment-refractory OCD are reviewed.
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Only around 40-60% of OCD patients improve following SRI intervention.
“only around 40–60% of patients improve following SRI intervention”
From Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction (2023) · cites this paper as Dougherty et al., 2004
Cites
McDougle, C. J., Epperson, C. N., Pelton, G. H., Wasylink, S., & Price, L. H. (2000) · Archives of General Psychiatry · doi:10.1001/archpsyc.57.8.794 · Cited by 571 · see citing works
Dougherty, D. D., Baer, L., Cosgrove, G. R., Cassem, E. H., Price, B. H., Nierenberg, A. A., Jenike, M. A., & Rauch, S. L. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.2.269 · Cited by 354 · see citing works
Self-citationNeurosurgery for intractable obsessive-compulsive disorder and depression: critical issues
Greenberg, B. D., Price, L. H., Rauch, S. L., Friehs, G., Noren, G., Malone, D., Carpenter, L. L., Rezai, A. R., & Rasmussen, S. A. (2003) · Neurosurgery Clinics of North America · doi:10.1016/s1042-3680(03)00005-6 · Cited by 300 · see citing works
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Invasive circuitry-based neurotherapeutics: stereotactic ablation and deep brain stimulation for OCD
Greenberg, B. D., Rauch, S. L., & Haber, S. N. (2010) · Neuropsychopharmacology · doi:10.1038/npp.2009.128 · Cited by 359 · see citing works
Self-citationFive-Year Course of Obsessive-Compulsive Disorder: Predictors of Remission and Relapse [CME]
Eisen, J. L., Sibrava, N. J., Boisseau, C. L., Mancebo, M. C., Stout, R. L., Pinto, A., & Rasmussen, S. A. (2013) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.12m07657 · Cited by 248 · see citing works
Dopaminergic control of cognitive flexibility in humans and animals
Klanker, M., Feenstra, M., & Denys, D. (2013) · Frontiers in Neuroscience · doi:10.3389/fnins.2013.00201 · Cited by 209 · see citing works
Heterogeneity of obsessive-compulsive disorder: A literature review
Lochner, C., & Stein, D. J. (2003) · Harvard Review of Psychiatry · doi:10.1080/10673220303949 · Cited by 143 · see citing works
Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction
Jalal, B., Chamberlain, S. R., & Sahakian, B. J. (2023) · Brain and Behavior · doi:10.1002/brb3.3000 · Cited by 111 · see citing works
“…is intriguing but inconclusive (Maia & Cano-Colino, 2015), and the exact role of 5-HT in OCD remains elusive (Stein, 2002; Westenberg et al., 2007), further complicated by the fact that only around 40–60% of patients improve following SRI intervention (Dougherty et al., 2004;Menzies et al., 2008).”
BackgroundObsessive-compulsive disorder: update on assessment and treatment.
BJÖRGVINSSON, T., HART, J., & HEFFELFINGER, S. (2007) · Journal of Psychiatric Practice® · doi:10.1097/01.pra.0000300122.76322.ad · Cited by 65 · see citing works
Brown, H. D., Amodeo, D. A., Sweeney, J. A., & Ragozzino, M. E. (2012) · Journal of Psychopharmacology · doi:10.1177/0269881111430749 · Cited by 56 · see citing works
- Authors
- Dougherty, D. D., Rauch, S. L., & Jenike, M. A.
- Affiliations
- Harvard University (US)
- Corresponding author
- Dougherty, Darin D.
- Venue
- Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2004-09-10
- Volume
- 60
- Issue
- 11
- Pages
- 1195-1202
- ISSN
- 0021-9762 (ISSN-L)
- 1097-4679
- OpenAlex
- W2017491907
- Cited by
- 83
- References
- 3
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 4 · 2016: 3 · 2015: 5 · 2014: 6 · 2013: 5 · 2012: 4
- FWCI
- 6.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- obsessive-compulsive disorder, pharmacotherapy, serotonin reuptake inhibitors, antipsychotic drugs, treatment-refractory OCD, neurosurgical treatment, deep brain stimulation, device therapy
- MeSH terms
- Clinical Trials as Topic, Desensitization, Psychologic, Dose-Response Relationship, Drug, Drug Administration Schedule, Drug Therapy, Combination, Electric Stimulation Therapy, Humans, Magnetics, Obsessive-Compulsive Disorder, Psychosurgery, Antipsychotic Agents, Treatment Outcome, Selective Serotonin Reuptake Inhibitors
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