World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders–Version 3. Part II: OCD and PTSD

Borwin Bandelow, Christer Allgulander, David S. Baldwin, Daniel Lucas da Conceição Costa, Damiaan Denys, Nesrin Dilbaz, Katharina Domschke, Eric Hollander, Siegfried Kasper, Hans Jürgen Möller, Elias Eriksson, Naomi A. Fineberg, Josef Hättenschwiler, Hisanobu Kaiya, Tatiana Karavaeva, Martin A. Katzman, Yong Ku Kim, Takeshi Inoue, Leslie Lim, Vasilios MasdrakisJosé M. Menchón, Euripedes C. Miguel, Antônio E. Nardi, Stefano Pallanti, Giampaolo Perna, Dan Rujescu, Vladan Starcevic, Dan J. Stein, Shih Jen Tsai, Michael Van Ameringen, Anna Vasileva, Zhen Wang, Joseph Zohar

Research output: Contribution to journalArticlepeer-review

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Abstract

Aim: This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive–Compulsive and Posttraumatic Stress Disorders which was published in 2002 and revised in 2008. Method: A consensus panel of 34 international experts representing 22 countries developed recommendations based on efficacy and acceptability of the treatments. In this version, not only medications but also psychotherapies and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medication treatments. Result: The present paper (Part II) contains recommendations based on published randomised controlled trials (RCTs) for the treatment of OCD (n = 291) and PTSD (n = 234) in children, adolescents, and adults. The accompanying paper (Part I) contains the recommendations for the treatment of anxiety disorders. For OCD, first-line treatments are selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioural therapy (CBT). Internet-CBT was also superior to active controls. Several second-line medications are available, including clomipramine. For treatment-resistant cases, several options are available, including augmentation of SSRI treatment with antipsychotics and other drugs. Other non-pharmacological treatments, including repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation (DBS) and others were also evaluated. For PTSD, SSRIs and the SNRI venlafaxine are first-line treatments. CBT is the psychotherapy modality with the best body of evidence. For treatment-unresponsive patients, augmentation of SSRI treatment with antipsychotics may be an option. Conclusion: OCD and PTSD can be effectively treated with CBT and medications.

Original languageEnglish (US)
JournalWorld Journal of Biological Psychiatry
DOIs
StateAccepted/In press - 2022

Keywords

  • children
  • guideline
  • Obsessive-compulsive disorder
  • posttraumatic stress disorder
  • treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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