Original Research Prim Care Companion CNS Disord March 2022

Early Improvement as a Predictor of Treatment Response in Patients With Obsessive-Compulsive Disorder: A 12-Week Randomized Trial of Sertraline and Fluvoxamine

PCC CNS Disord 2022;24(2):10.4088/PCC.21m03065

Full Article Read the complete peer-reviewed article in Prim Care Companion CNS Disord. Clinical Summary When starting an SSRI for obsessive-compulsive disorder, clinicians often wait 12 weeks before deciding whether the trial has worked, even though delayed improvement prolongs symptoms and uncertainty for patients. This study asks a practical question: can symptom change early in treatment identify who is likely to respond by 12 weeks, and does that differ between sertraline and fluvoxamine? FAQ Can early improvement on an SSRI predict whether a patient with OCD will respond by 12 weeks?

Key Takeaways In this drug-naive sample, OCD symptoms were of moderate baseline severity, with a mean baseline ± SD YBOCS score of 23.48 ± 6.29, and the mean YBOCS score fell to 12.88 by 12 weeks (P = .000). Clinical Guide How can clinicians use early symptom change on the YBOCS to estimate whether a drug-naive patient with OCD will respond to an SSRI by 12 weeks? Clinical Guide How should clinicians choose between sertraline and fluvoxamine when initiating SSRI treatment for a drug-naive patient with OCD?