Obsessive compulsive disorder, depression, and fluoxetine

Eric Hollander, L. Mullen, C. M. DeCaria, A. Skodol, F. R. Schneier, M. R. Liebowitz, D. F. Klein

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Fluoxetine, a selective serotonin reuptake blocker, is an antidepressant medication that has also been shown in open clinical trials and one controlled trial to be effective in the treatment of obsessive compulsive disorder (OCD). OCD is often complicated by depression, and depressive symptoms may interfere with response to both pharmacologic and behavioral treatments. Method: We describe pilot data from 10 out-patients who met DSM-III-R criteria for OCD in whom the possibility of a depressive reaction or lack of antidepressant response occurred during an open trial of fluoxetine. Results: Rapid increase in fluoxetine dose to high doses was associated with depressive symptoms in 6 patients. In 8 patients, improvement in depression was associated with addition of a tricyclic antidepressant to fluoxetine treatment. In 5 patients, both OCD and depressive symptoms improved when the patient was switched to the partially selective serotonin reuptake blocker clomipramine. Conclusion: This paper serves to alert clinicians to the possibility of a depressive reaction, or lack of antidepressant response, to fluoxetine in OCD patients. This possibility can only be resolved scientifically by adequately controlled experimental trials. If depression occurs, combined fluoxetine and tricyclic treatment, or a switch to a partially selective serotonin reuptake inhibitor, may be helpful. Special considerations and side effects of combined fluoxetine-tricyclic treatment are described.

Original languageEnglish (US)
Pages (from-to)418-422
Number of pages5
JournalJournal of Clinical Psychiatry
Volume52
Issue number10
StatePublished - 1991
Externally publishedYes

Fingerprint

Fluoxetine
Obsessive-Compulsive Disorder
Depression
Antidepressive Agents
Serotonin
Therapeutics
Clomipramine
Tricyclic Antidepressive Agents
Controlled Clinical Trials
Serotonin Uptake Inhibitors
Diagnostic and Statistical Manual of Mental Disorders
Outpatients

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Hollander, E., Mullen, L., DeCaria, C. M., Skodol, A., Schneier, F. R., Liebowitz, M. R., & Klein, D. F. (1991). Obsessive compulsive disorder, depression, and fluoxetine. Journal of Clinical Psychiatry, 52(10), 418-422.

Obsessive compulsive disorder, depression, and fluoxetine. / Hollander, Eric; Mullen, L.; DeCaria, C. M.; Skodol, A.; Schneier, F. R.; Liebowitz, M. R.; Klein, D. F.

In: Journal of Clinical Psychiatry, Vol. 52, No. 10, 1991, p. 418-422.

Research output: Contribution to journalArticle

Hollander, E, Mullen, L, DeCaria, CM, Skodol, A, Schneier, FR, Liebowitz, MR & Klein, DF 1991, 'Obsessive compulsive disorder, depression, and fluoxetine', Journal of Clinical Psychiatry, vol. 52, no. 10, pp. 418-422.
Hollander E, Mullen L, DeCaria CM, Skodol A, Schneier FR, Liebowitz MR et al. Obsessive compulsive disorder, depression, and fluoxetine. Journal of Clinical Psychiatry. 1991;52(10):418-422.
Hollander, Eric ; Mullen, L. ; DeCaria, C. M. ; Skodol, A. ; Schneier, F. R. ; Liebowitz, M. R. ; Klein, D. F. / Obsessive compulsive disorder, depression, and fluoxetine. In: Journal of Clinical Psychiatry. 1991 ; Vol. 52, No. 10. pp. 418-422.
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