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A 2012 Evidence-Based Algorithm for the Pharmacotherapy for Obsessive-Compulsive Disorder

  • ANXIETY DISORDERS (DJ STEIN, SECTION EDITOR)
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Abstract

There is a need to synthesize the growing body of literature on the pharmacotherapeutic management of patients with obsessive-compulsive disorder for clinicians working at a primary care level. We have aimed to generate a simple, easy-to-follow algorithm for the primary care practitioner. This seven-step algorithm addresses diagnosis of obsessive-compulsive disorder, initiation of pharmacotherapy, monitoring and maintenance treatment, and guidelines for the management of patients who are resistant to initial therapy. In creating this algorithm, we have drawn on the body of published evidence, as well as on expert opinion.

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Disclosure

Dr. Stein has received research grants and/or served as a consultant for Abbott Laboratories, AstraZeneca, Eli Lilly and Company, GlaxoSmithKline, Jazz Pharmaceuticals, Johnson & Johnson, H. Lundbeck A/S, Orion Pharma, Pfizer, Pharmacia, Roche, Servier, Solvay Pharmaceuticals, Sumitomo, Takeda, Tikvah, and Wyeth.

Dr. Fineberg has served as a consultant for H. Lundbeck A/S, GlaxoSmithKline, and Servier; has received research support from H. Lundbeck A/S, GlaxoSmithKline, AstraZeneca, Wellcome, Cephalon, ECNP, and Servier; has received honoraria for giving lectures at scientific meetings from Janssen, Jazz Pharmaceuticals, H. Lundbeck A/S, Servier, AstraZeneca, and Wyeth; has received royalties from Martin Dunitz Press and Oxford University Press; has had travel/accommodations expenses covered/reimbursed by H. Lundbeck A/S, Servier, Wyeth, ECNP, BAP, and the Royal College of Psychiatrists; and has received financial support to attend scientific meetings from Janssen Pharmaceutica, Bristol-Myers Squibb, Jazz Pharmaceuticals, H. Lundbeck A/S, Servier, AstraZeneca, Wyeth, Cephalon, and the International College of OC Spectrum Disorders.

Dr. Fontanelle has served as a consultant for H. Lundbeck A/S; has received payment for development of educational presentations from H. Lundbeck A/S; has received grant support from the National Council for Scientific and Technological Development (CNPq) Research Productivity Scholarship and Young Scientist of Our State and the Rio de Janeiro State Research Support Foundation (FAPERJ); and has had travel/accommodations expenses reimbursed by Solvay Pharmaceuticals, Servier, H. Lundbeck A/S, and Abbott Laboratories.

Dr. Simpson has served as a consultant for Pfizer; received research funding from the National Institute of Mental Health, Neuropharm Ltd, Transcept Pharmaceuticals, and Janssen Pharmaceutica; received honoraria from Transcept Pharmaceuticals; and received royalties from Up to Date and Cambridge University Press.

Drs. Koen and Matsunaga reported no potential conflicts of interest relevant to this article.

Author information

Authors and Affiliations

  1. University of Cape Town Department of Psychiatry, Groote Schuur Hospital J-2, Anzio Road, Observatory 7925, Cape Town, South Africa

    Dan J. Stein & Nastassja Koen

  2. Department of Psychiatry, Queen Elizabeth II Hospital, Howlands, Welwyn Garden City, Hertfordshire, AL7 4HQ, England, UK

    Naomi Fineberg

  3. Department of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Leonardo F. Fontenelle

  4. Department of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, Japan

    Hisato Matsunaga

  5. Department of Psychiatry, Brockton Veteran’s Administration Medical Center, 940 Belmont Street, Brockton, MA, 02301, USA

    David Osser

  6. Department of Psychiatry, Columbia University and NYS Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA

    H. Blair Simpson

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  1. Dan J. Stein
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  2. Nastassja Koen
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  4. Leonardo F. Fontenelle
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Correspondence to Dan J. Stein.

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Stein, D.J., Koen, N., Fineberg, N. et al. A 2012 Evidence-Based Algorithm for the Pharmacotherapy for Obsessive-Compulsive Disorder. Curr Psychiatry Rep 14, 211–219 (2012). https://doi.org/10.1007/s11920-012-0268-9

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