Sertraline in obsessive-compulsive disorder: a double-blind comparison with placebo

Article Abstract:

The most successful drug therapy for patients with obsessive-compulsive disorders has involved antidepressant drugs, especially those that affect brain serotonergic systems. Clomipramine has been shown to be effective in treating obsessive-compulsive disorders, but side effects are common and limit the usefulness of this drug. Studies have shown that a new experimental serotonergic agent, sertraline, is an effective antidepressant. Thus far, sertraline has not been used with patients with obsessive-compulsive disorders. In this study, 19 patients with obsessive-compulsive disorders were treated with sertraline (10 patients) or a placebo (nine patients). The patients were randomly assigned to one of the two groups for a 10-week period. Patients taking sertraline were given up to 200 mg per day, and only two patients experienced side effects; patients taking the placebo reported a similar frequency of side effects. No clinically significant changes associated with the drug were evident in physical examinations and laboratory tests. However, no significant differences were observed in clinical characteristics between the patients treated with sertraline and the patients given placebo. The results indicate that sertraline is not effective in treating patients with obsessive-compulsive disorders. Explanations to account for this lack of response include incorrect therapeutic dosage; the small size of the patient groups; and pharmacological properties of sertraline that make it ineffective for obsessive-compulsive disorder, despite the fact that it is similar to other agents which have been effective. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sertraline

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Obsessive-compulsive disorder: a double-blind, placebo- controlled trial of clomipramine in 27 patients

Article Abstract:

According to the DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders, third edition, revised), obsessive-compulsive disorder, or obsessive-compulsive neurosis, is a condition characterized by recurrent obsessions or compulsions which are severe enough to cause marked distress, become time consuming, or interfere with one's normal activities or relationships with others. A study was performed of 27 outpatients who suffered from an obsessive-compulsive disorder and who met the criteria indicated in the DSM-III-R. The objective was to test the effectiveness of the drug clomipramine. A ten-week trial study was performed where 13 subjects were randomly given clomipramine and 14 subjects were given an inactive substance, a placebo. Clomipramine is a tricyclic antidepressant manufactured by the Ciba-Geigy Pharmaceutical Company, which partially supported this research. The drug is not available in the US but can be obtained by prescription in Europe, Canada and Mexico. Four measurements of the patients were taken using the following scales: the Hamilton Rating Scale for Depression, the Global Assessment of Obsessive-Compulsive Symptoms, the Yale-Brown Obsessive-Compulsive Scale, and the National Institute of Mental Health (NIMH) Obsessive-Compulsive Scale. The results of these tests indicated that clomipramine was much more effective in relieving the symptoms of obsessive-compulsive neurosis than the placebo, and these results are consistent with earlier conclusions of smaller studies. Other antidepressants, such as fluvoxamine, sertraline, and fluoxetine, are also mentioned as therapeutic options because clomipramine is not available in the US.

Clinical trials, Clomipramine

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Open trial of fluoxetine in obsessive-compulsive disorder

Article Abstract:

In a 12-week open trial (i.e., an ongoing experimentation period), fluoxetine was given to 61 patients who were diagnosed with obsessive-compulsive disorder. Fluoxetine is known to be an antidepressant which functions biochemically as a serotonergic agonist, a chemical that competes with and inhibits the presynaptic uptake of serotonin as an neurotransmitter. Therefore, fluoxetine increases the level of serotonin in the brain. It has been hypothesized that abnormalities exist in the serotonergic mechanism of patients with obsessive-compulsive disorders. Results of data after 12 weeks showed a significant reduction in symptoms of both obsessive-compulsive disorder and depression in all patients. These preliminary results reenforce the hypothesis that serotonergic abnormalities exist in at least some patients who suffer from obsessive-compulsive disorder. This drug has a relatively low rate of known side effects and the continuation of treatment with fluoxetine for patients with this disorder was recommended on a trial basis. Further research to obtain more data on the efficacy of fluoxetine and to develop guidelines for optimal dosage of this drug is needed.

Fluoxetine

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