Dr. Adams
03-01-2008, 08:56 AM
"Selective serotonin-reuptake inhibitor (SSRI) antidepressants were almost twice as likely as placebo to confer modest improvement in symptoms of obsessive-compulsive disorder (OCD) among patients who responded to treatment in 17 short-term studies published from 1989 to 2004.
The 5 SSRIs that were examined — citalopram (Celexa, Forest Pharmaceuticals), fluoxetine (Prozac, Eli Lilly), fluvoxamine (Luvox, Solvay Pharmaceuticals), paroxetine (Paxil, GlaxoSmithKline), and sertraline (Zoloft, Pfizer) — appeared to be equally effective, although individual drugs had different adverse effects, most commonly nausea, headache, and insomnia.
This systematic review provides evidence that SSRIs are moderately effective, at least in the short term, in adults with OCD of varying duration. However, treatment decisions need to take into account the potential adverse effects with SSRIs, and in some patients, alternative treatments such as cognitive behavioral therapy may need to be considered, they note.
The necessary duration of SSRI treatment in OCD and the long-term outcomes remain to be determined.
The investigators determined that if 10% of OCD patients might be expected to recover without treatment (a very conservative estimate), then 12 patients would need to be treated with SSRIs to achieve improvement for 1 additional patient. Assuming that 20% of patients might recover without treatment (a conservative estimate), then 6 patients would need to be treated for 1 to improve.
Adverse effects — most commonly nausea, headache, and insomnia — were significantly worse with an SSRI than with placebo. Other commonly reported adverse effects included dyspepsia, diarrhea, constipation, anxiety, fatigue, sedation, somnolence, asthenia, and forgetfulness.
The effect of SSRIs in achieving improvement of OCD symptoms is modest, and the clinical utility of these interventions should be weighed against the adverse effects, particularly those that impact on quality of life, such as sexual adverse effects," the group summarizes."
The 5 SSRIs that were examined — citalopram (Celexa, Forest Pharmaceuticals), fluoxetine (Prozac, Eli Lilly), fluvoxamine (Luvox, Solvay Pharmaceuticals), paroxetine (Paxil, GlaxoSmithKline), and sertraline (Zoloft, Pfizer) — appeared to be equally effective, although individual drugs had different adverse effects, most commonly nausea, headache, and insomnia.
This systematic review provides evidence that SSRIs are moderately effective, at least in the short term, in adults with OCD of varying duration. However, treatment decisions need to take into account the potential adverse effects with SSRIs, and in some patients, alternative treatments such as cognitive behavioral therapy may need to be considered, they note.
The necessary duration of SSRI treatment in OCD and the long-term outcomes remain to be determined.
The investigators determined that if 10% of OCD patients might be expected to recover without treatment (a very conservative estimate), then 12 patients would need to be treated with SSRIs to achieve improvement for 1 additional patient. Assuming that 20% of patients might recover without treatment (a conservative estimate), then 6 patients would need to be treated for 1 to improve.
Adverse effects — most commonly nausea, headache, and insomnia — were significantly worse with an SSRI than with placebo. Other commonly reported adverse effects included dyspepsia, diarrhea, constipation, anxiety, fatigue, sedation, somnolence, asthenia, and forgetfulness.
The effect of SSRIs in achieving improvement of OCD symptoms is modest, and the clinical utility of these interventions should be weighed against the adverse effects, particularly those that impact on quality of life, such as sexual adverse effects," the group summarizes."