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Pharmacological Treatment of Obsessive-Compulsive Disorder

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Book cover Behavioral Neurobiology of Anxiety and Its Treatment

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 2))

Abstract

Obsessive-compulsive disorder (OCD) is a disabling neuropsychiatric disorder. Two treatments have been proven efficacious for the symptoms of OCD: pharmacological treatment with serotonin reuptake inhibitors and cognitive-behavioral therapy (CBT) consisting of exposure and response prevention. This chapter will focus on pharmacological treatments. The only medications which have proved effective for OCD in multisite randomized controlled trials are serotonin reuptake inhibitors, which include clomipramine (a noradrenergic and serotonergic reuptake inhibitor) and the selective serotonin reuptake inhibitors. General guidelines for the use of these medication will be presented, focusing on key issues that arise in clinical practice such as what dose to use, time to response, management of side effects, and duration of treatment. Because many OCD patients will have either a partial response or no response to these medications, evidence-based strategies for managing both partial responders and nonresponders will be described, including the evidence supporting augmentation with other medications or with CBT, and switching to other medications. Finally, novel strategies which are based on an increased understanding of the brain mechanisms underlying OCD and which are under investigation will be reviewed.

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Authors and Affiliations

  1. Columbia University and the New York State Psychiatric Institute, New York, USA

    Helen Blair Simpson

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  1. Helen Blair Simpson
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Editors and Affiliations

  1. Dept. Psychiatry, University of California, San Diego, Gilman Drive 9500, La Jolla, 92093-0985, USA

    Murray B. Stein

  2. Research & Development, CNS - Affective Spectrum, Johnson & Johnson Pharmaceutical, Turnhoutseweg 30, Beerse, 2340, Belgium

    Thomas Steckler

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Simpson, H.B. (2009). Pharmacological Treatment of Obsessive-Compulsive Disorder. In: Stein, M., Steckler, T. (eds) Behavioral Neurobiology of Anxiety and Its Treatment. Current Topics in Behavioral Neurosciences, vol 2. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2009_12

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