WCA Recommendations for the Long-Term Treatment of Obsessive-Compulsive Disorder in Adults

John H. Greist, Borwin Bandelow, Eric Hollander, Donatella Marazziti, Stuart A. Montgomery, David J. Nutt, Ahmed Okasha, Richard P. Swinson, Joseph Zohar

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

What are the latest psychotherapeutic and pharmacotherapeutic treatment recommendations for obsessive-compulsive disorder (OCD)? OCD is a relatively common disorder with a lifetime prevalence of ∼2% in the general population. It often has an early onset, usually in childhood or adolescence, and frequently becomes chronic and disabling if left untreated. High associated healthcare utilization and costs, and reduced productivity resulting in loss of earning, pose a huge economic burden to OCD patients and their families, employers, and society. OCD is characterized by the presence of obsessions and compulsions that are time-consuming, cause marked distress, or significantly interfere with a person's functioning. Most patients with OCD experience symptoms throughout their lives and benefit from long-term treatment. Both psychotherapy and pharmacotherapy are recommended, either alone or in combination, for the treatment of OCD. Cognitive-behavioral therapy is the psychotherapy of choice. Pharmacologic treatment options include the tricyclic antidepressant clomipramine and the selective serotonin reuptake inhibitors (SSRIs) citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline. These have all shown benefit in acute treatment trials; clomipramine, fluvoxamine, fluoxetine, and sertraline have also demonstrated benefit in long-term treatment trials (at least 24 weeks), and clomipramine, sertraline, and fluvoxamine have United States Food and Drug Administration approvals for use in children and adolescents. Available treatment guidelines recommend first-line use of an SSRI (ie, fluoxetine, fluvoxamine, paroxetine, sertraline, or citalopram) in preference to clomipramine, due to the latter's less favorable adverse-event profile. Further, pharmacotherapy for a minimum of 1-2 years is recommended before very gradual withdrawal may be considered.

Original languageEnglish (US)
Pages (from-to)7-16
Number of pages10
JournalCNS Spectrums
Volume8
Issue number8 SUPPL. 1
StatePublished - Aug 2003
Externally publishedYes

Fingerprint

Obsessive-Compulsive Disorder
Fluvoxamine
Sertraline
Clomipramine
Fluoxetine
Paroxetine
Citalopram
Serotonin Uptake Inhibitors
Psychotherapy
Therapeutics
Obsessive Behavior
Drug Approval
Drug Therapy
Tricyclic Antidepressive Agents
Cognitive Therapy
United States Food and Drug Administration
Health Care Costs
Economics
Guidelines
Population

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology

Cite this

Greist, J. H., Bandelow, B., Hollander, E., Marazziti, D., Montgomery, S. A., Nutt, D. J., ... Zohar, J. (2003). WCA Recommendations for the Long-Term Treatment of Obsessive-Compulsive Disorder in Adults. CNS Spectrums, 8(8 SUPPL. 1), 7-16.

WCA Recommendations for the Long-Term Treatment of Obsessive-Compulsive Disorder in Adults. / Greist, John H.; Bandelow, Borwin; Hollander, Eric; Marazziti, Donatella; Montgomery, Stuart A.; Nutt, David J.; Okasha, Ahmed; Swinson, Richard P.; Zohar, Joseph.

In: CNS Spectrums, Vol. 8, No. 8 SUPPL. 1, 08.2003, p. 7-16.

Research output: Contribution to journalArticle

Greist, JH, Bandelow, B, Hollander, E, Marazziti, D, Montgomery, SA, Nutt, DJ, Okasha, A, Swinson, RP & Zohar, J 2003, 'WCA Recommendations for the Long-Term Treatment of Obsessive-Compulsive Disorder in Adults', CNS Spectrums, vol. 8, no. 8 SUPPL. 1, pp. 7-16.
Greist JH, Bandelow B, Hollander E, Marazziti D, Montgomery SA, Nutt DJ et al. WCA Recommendations for the Long-Term Treatment of Obsessive-Compulsive Disorder in Adults. CNS Spectrums. 2003 Aug;8(8 SUPPL. 1):7-16.
Greist, John H. ; Bandelow, Borwin ; Hollander, Eric ; Marazziti, Donatella ; Montgomery, Stuart A. ; Nutt, David J. ; Okasha, Ahmed ; Swinson, Richard P. ; Zohar, Joseph. / WCA Recommendations for the Long-Term Treatment of Obsessive-Compulsive Disorder in Adults. In: CNS Spectrums. 2003 ; Vol. 8, No. 8 SUPPL. 1. pp. 7-16.
@article{64a649f03fe845f5b7ee72d0f1676838,
title = "WCA Recommendations for the Long-Term Treatment of Obsessive-Compulsive Disorder in Adults",
abstract = "What are the latest psychotherapeutic and pharmacotherapeutic treatment recommendations for obsessive-compulsive disorder (OCD)? OCD is a relatively common disorder with a lifetime prevalence of ∼2{\%} in the general population. It often has an early onset, usually in childhood or adolescence, and frequently becomes chronic and disabling if left untreated. High associated healthcare utilization and costs, and reduced productivity resulting in loss of earning, pose a huge economic burden to OCD patients and their families, employers, and society. OCD is characterized by the presence of obsessions and compulsions that are time-consuming, cause marked distress, or significantly interfere with a person's functioning. Most patients with OCD experience symptoms throughout their lives and benefit from long-term treatment. Both psychotherapy and pharmacotherapy are recommended, either alone or in combination, for the treatment of OCD. Cognitive-behavioral therapy is the psychotherapy of choice. Pharmacologic treatment options include the tricyclic antidepressant clomipramine and the selective serotonin reuptake inhibitors (SSRIs) citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline. These have all shown benefit in acute treatment trials; clomipramine, fluvoxamine, fluoxetine, and sertraline have also demonstrated benefit in long-term treatment trials (at least 24 weeks), and clomipramine, sertraline, and fluvoxamine have United States Food and Drug Administration approvals for use in children and adolescents. Available treatment guidelines recommend first-line use of an SSRI (ie, fluoxetine, fluvoxamine, paroxetine, sertraline, or citalopram) in preference to clomipramine, due to the latter's less favorable adverse-event profile. Further, pharmacotherapy for a minimum of 1-2 years is recommended before very gradual withdrawal may be considered.",
author = "Greist, {John H.} and Borwin Bandelow and Eric Hollander and Donatella Marazziti and Montgomery, {Stuart A.} and Nutt, {David J.} and Ahmed Okasha and Swinson, {Richard P.} and Joseph Zohar",
year = "2003",
month = "8",
language = "English (US)",
volume = "8",
pages = "7--16",
journal = "CNS Spectrums",
issn = "1092-8529",
publisher = "MBL Communications",
number = "8 SUPPL. 1",

}

TY - JOUR

T1 - WCA Recommendations for the Long-Term Treatment of Obsessive-Compulsive Disorder in Adults

AU - Greist, John H.

AU - Bandelow, Borwin

AU - Hollander, Eric

AU - Marazziti, Donatella

AU - Montgomery, Stuart A.

AU - Nutt, David J.

AU - Okasha, Ahmed

AU - Swinson, Richard P.

AU - Zohar, Joseph

PY - 2003/8

Y1 - 2003/8

N2 - What are the latest psychotherapeutic and pharmacotherapeutic treatment recommendations for obsessive-compulsive disorder (OCD)? OCD is a relatively common disorder with a lifetime prevalence of ∼2% in the general population. It often has an early onset, usually in childhood or adolescence, and frequently becomes chronic and disabling if left untreated. High associated healthcare utilization and costs, and reduced productivity resulting in loss of earning, pose a huge economic burden to OCD patients and their families, employers, and society. OCD is characterized by the presence of obsessions and compulsions that are time-consuming, cause marked distress, or significantly interfere with a person's functioning. Most patients with OCD experience symptoms throughout their lives and benefit from long-term treatment. Both psychotherapy and pharmacotherapy are recommended, either alone or in combination, for the treatment of OCD. Cognitive-behavioral therapy is the psychotherapy of choice. Pharmacologic treatment options include the tricyclic antidepressant clomipramine and the selective serotonin reuptake inhibitors (SSRIs) citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline. These have all shown benefit in acute treatment trials; clomipramine, fluvoxamine, fluoxetine, and sertraline have also demonstrated benefit in long-term treatment trials (at least 24 weeks), and clomipramine, sertraline, and fluvoxamine have United States Food and Drug Administration approvals for use in children and adolescents. Available treatment guidelines recommend first-line use of an SSRI (ie, fluoxetine, fluvoxamine, paroxetine, sertraline, or citalopram) in preference to clomipramine, due to the latter's less favorable adverse-event profile. Further, pharmacotherapy for a minimum of 1-2 years is recommended before very gradual withdrawal may be considered.

AB - What are the latest psychotherapeutic and pharmacotherapeutic treatment recommendations for obsessive-compulsive disorder (OCD)? OCD is a relatively common disorder with a lifetime prevalence of ∼2% in the general population. It often has an early onset, usually in childhood or adolescence, and frequently becomes chronic and disabling if left untreated. High associated healthcare utilization and costs, and reduced productivity resulting in loss of earning, pose a huge economic burden to OCD patients and their families, employers, and society. OCD is characterized by the presence of obsessions and compulsions that are time-consuming, cause marked distress, or significantly interfere with a person's functioning. Most patients with OCD experience symptoms throughout their lives and benefit from long-term treatment. Both psychotherapy and pharmacotherapy are recommended, either alone or in combination, for the treatment of OCD. Cognitive-behavioral therapy is the psychotherapy of choice. Pharmacologic treatment options include the tricyclic antidepressant clomipramine and the selective serotonin reuptake inhibitors (SSRIs) citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline. These have all shown benefit in acute treatment trials; clomipramine, fluvoxamine, fluoxetine, and sertraline have also demonstrated benefit in long-term treatment trials (at least 24 weeks), and clomipramine, sertraline, and fluvoxamine have United States Food and Drug Administration approvals for use in children and adolescents. Available treatment guidelines recommend first-line use of an SSRI (ie, fluoxetine, fluvoxamine, paroxetine, sertraline, or citalopram) in preference to clomipramine, due to the latter's less favorable adverse-event profile. Further, pharmacotherapy for a minimum of 1-2 years is recommended before very gradual withdrawal may be considered.

UR - http://www.scopus.com/inward/record.url?scp=1542289622&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1542289622&partnerID=8YFLogxK

M3 - Article

VL - 8

SP - 7

EP - 16

JO - CNS Spectrums

JF - CNS Spectrums

SN - 1092-8529

IS - 8 SUPPL. 1

ER -