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Refractory Obsessive-Compulsive Disorder: State-of-the-Art Treatment

Eric Hollander, MD; Carol A. Bienstock, BA; Lorrin M. Koran, MD; Stefano Pallanti, MD; Donatella Marazziti, MD; Steven A. Rasmussen, MD; Luigi Ravizza, MD; Chawkie Benkelfat, MD; Sanjaya Saxena, MD; Benjamin D. Greenberg, MD, PhD; Yehuda Sasson, MD; and Joseph Zohar, MD

Published: June 1, 2002

Article Abstract

Nonresponse to treatment in obsessive-compulsive disorder is common, associated with substantialimpairment, and understudied. Little practical advice is available to clinicians on next-step treatmentstrategies for patients who have not responded well to 2 trials of selective serotonin reuptake inhibitors(SSRIs). Available options include continuation of SSRI treatment, switching to another SSRI or selectiveserotonin-norepinephrine reuptake inhibitor, augmenting with atypical neuroleptics or cognitivebehavioraltherapy, or utilizing novel treatment approaches. The authors synthesize state-of-the-art treatmentand give practical advice for clinicians.’ ‹

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