Serotonin-Norepinephrine Reuptake Inhibitors in the Treatment of Obsessive-Compulsive Disorder: A Critical Review.
J Clin Psychiatry 2006;67:600-610
© 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
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.