Effectiveness of Pharmacotherapy for Body Dysmorphic Disorder: A Chart-Review Study
J Clin Psychiatry 2001;62(9):721-727
© Copyright 2014 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Research on the
pharmacotherapy of body dysmorphic disorder (BDD) is limited. No
placebo-controlled, continuation, maintenance, or discontinuation
studies have been published. Only one augmentation study has been
Method: In this chart-review study of 90
patients with DSM-IV BDD treated for up to 8 years by the first 2
authors (K.A.P., R.S.A.) in their clinical practice, response to
a variety of medications, including augmentation strategies, was
assessed. The relapse rate with medication discontinuation was
Results: All subjects received a
serotonin reuptake inhibitor (SRI), with 63.2% (55/87) of
adequate SRI trials resulting in improvement in BDD symptoms;
similar response rates were obtained for each type of SRI.
Discontinuation of an effective SRI resulted in relapse in 83.8%
(31/37) of cases. Response rates to selective SRI augmentation
were clomipramine, 44.4% (4/9) of trials; buspirone, 33.3%
(12/36) of trials; lithium, 20.0% (1/5); methylphenidate, 16.7%
(1/6); and antipsychotics, 15.4% (2/13) of trials.
Conclusion: These findings from a
clinical setting suggest that a majority of BDD patients improve
with an SRI and that all SRIs appear effective. Certain SRI
augmentation strategies may be beneficial. The high relapse rate
with SRI discontinuation suggests that long-term treatment is
often necessary. These preliminary findings require confirmation
in placebo-controlled efficacy studies and effectiveness studies.