Serotonin-norepinephrine reuptake inhibitors in the treatment of obsessive-compulsive disorder: A critical review

Bernardo Dell'Osso, Gerald Nestadt, Andrea Allen, Eric Hollander

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Objective: To critically review the antiobsessional properties of serotonin-norepinephrine reuptake inhibitors (SNRIs) (venlafaxine and clomipramine) in the treatment of obsessive-compulsive disorder (OCD) as an alternative to selective serotonin reuptake inhibitors (SSRIs), which are currently considered the first-line treatment of OCD. Data Sources: A MEDLINE search was performed to identify clinical trials with the SNRIs venlafaxine and clomipramine published from 1996 to 2004 (keywords: SNRIs, venlafaxine, duloxetine, and clomipramine, each matched individually with the term OCD), focusing on the best-designed studies for inclusion. Data Synthesis: Much of the literature about SNRIs in OCD supports the efficacy of these compounds in the treatment of OCD. However, double-blind, placebo-controlled studies with venlafaxine are lacking, and the most relevant studies consist of active comparison trials between SNRIs and SSRIs. In these studies, SNRIs seem to be as effective as SSRIs in OCD; SNRIs might be preferred for patients with certain types of treatment-resistant OCD or those with particular comorbid conditions. A large number of placebo-controlled and active comparison trials with clomipramine document efficacy in OCD, and meta-analytic studies suggest a small superiority over SSRIs. Compared with clomipramine, the SNRI venlafaxine showed fewer side effects and better tolerability. Conclusion: The SNRIs may represent a valid alternative to the SSRIs, particularly in specific cases. Double-blind, placebo-controlled studies are, however, needed to confirm the positive findings reported by several studies with venlafaxine.

Original languageEnglish (US)
Pages (from-to)600-610
Number of pages11
JournalJournal of Clinical Psychiatry
Volume67
Issue number4
StatePublished - Apr 2006
Externally publishedYes

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Obsessive-Compulsive Disorder
Clomipramine
Serotonin Uptake Inhibitors
Therapeutics
Placebos
Serotonin and Noradrenaline Reuptake Inhibitors
Information Storage and Retrieval
MEDLINE
Venlafaxine Hydrochloride
Clinical Trials

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Serotonin-norepinephrine reuptake inhibitors in the treatment of obsessive-compulsive disorder : A critical review. / Dell'Osso, Bernardo; Nestadt, Gerald; Allen, Andrea; Hollander, Eric.

In: Journal of Clinical Psychiatry, Vol. 67, No. 4, 04.2006, p. 600-610.

Research output: Contribution to journalArticle

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