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Cited by 336Obsessive-Compulsive Spectrum DisordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychoanalysis and Psychopathology Research

Evidence-based pharmacotherapy of obsessive-compulsive disorder

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Fineberg, Naomi A., Brown, Angus, Reghunandanan, Samar, Pampaloni, Ilenia·2012·The International Journal of Neuropsychopharmacology
DOI 10.1017/s1461145711001829
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Abstract

Pharmacological strategies for the treatment of obsessive-compulsive disorder (OCD) continue to develop apace but deficiencies remain. We present an updated literature review of the evidence supporting available strategies. We aim to answer key questions including: (1) What are the first-line treatments? (2) Does pharmacotherapy improve health-related quality of life? (3) How do we evaluate clinical response and relapse? (4) How long should treatment continue? (5) Can we predict treatment outcomes? (6) What is the management of treatment-refractory OCD? Selective serotonin reuptake inhibitors (SSRIs) remain the pharmacological treatment of choice for most patients and are associated with improved health-related quality of life. However, discontinuation is associated with relapse and loss of quality of life, implying treatment should continue long term. A substantial minority of patients fail to respond to SSRI. Such patients may respond to strategies such as dose elevation or adjunctive antipsychotic, although long-term trials validating the effectiveness and tolerability of these strategies are relatively lacking. Newer compounds targeting other neurotransmitter systems, such as glutamate, are undergoing evaluation.

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  • A serotonin hypothesis implicating the serotonin system in the pathophysiology of OCD has been posited, arising from the therapeutic effects of serotonin reuptake inhibitors (SRIs) on OCD.

    “A “serotonin hypothesis” implicating the serotonin system in the pathophysiology of the disorder has been posited, arising from the therapeutic effects of the serotonin (5‐HT) reuptake inhibitors (SRIs) on OCD (Barr et al., 1993; Fineberg et al., 2012; Insel et al., 1985; for a recent study on the structure of the serotonin system using positron emission tomography [PET], see also Beliveau et al.,”

    From Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction (2023) · cites this paper as Fineberg et al., 2012

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Cited by

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Authors
Fineberg, N. A., Brown, A., Reghunandanan, S., & Pampaloni, I.
Affiliations
Queen Elizabeth II Hospital (GB)
Corresponding author
Fineberg, Naomi A.
ORCID
Venue
The International Journal of Neuropsychopharmacology
Publisher
Oxford University Press (OUP)
Published
2012-01-09
Volume
15
Issue
08
Pages
1173-1191
ISSN
  • 1461-1457 (ISSN-L)
  • 1469-5111
DOI
10.1017/s1461145711001829
OpenAlex
W2120747195
Cited by
336
References
34
Citations by year
2026: 10 · 2025: 14 · 2024: 9 · 2023: 9 · 2022: 9 · 2021: 15 · 2020: 53 · 2019: 18 · 2018: 11 · 2017: 15 · 2016: 9 · 2015: 22 · 2014: 16 · 2013: 7 · 2012: 14
FWCI
2.73
Type
journal article
Language
en
Open access
Locations
  • The International Journal of Neuropsychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Pfizer
  • AstraZeneca
  • GlaxoSmithKline
  • Servier
  • H. Lundbeck A/S
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, selective serotonin reuptake inhibitors, first-line therapy, health-related quality of life, relapse, treatment duration, treatment response prediction, treatment-refractory OCD, evidence-based treatment
MeSH terms
Humans, Obsessive-Compulsive Disorder, Randomized Controlled Trials as Topic, Databases, Factual, Selective Serotonin Reuptake Inhibitors, Evidence-Based Medicine

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