Key Takeaways

From the Authors As published in the article
  1. Almost two-thirds of drug-naive patients with obsessive-compulsive disorder show early response with sertraline and fluvoxamine.
  2. Early response predicts response at 12 weeks, with 77.8% sensitivity and 85.7% specificity.
  3. Both fluvoxamine and sertraline are equally effective and lead to significant reduction in Yale-Brown Obsessive-Compulsive Scale scores at 12 weeks.
Extended Takeaways
  1. 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).
  2. After a 2-week induction, the average minimum dose reached was 95 mg/d for sertraline and 102 mg/d for fluvoxamine; maximal tolerated doses later averaged 196 mg/d and 284 mg/d, respectively.
  3. Although mean YBOCS reductions did not differ significantly between drugs at any assessment point, categorical response favored fluvoxamine at 12 weeks (Pearson χ2 = 6.349, P = .012).
  4. Early nonresponse did not exclude later benefit: 40% (n = 20) did not show early response, and 8 of those patients still met response criteria by 12 weeks.
  5. No significant sociodemographic or clinical differences were found between early responders and nonresponders, suggesting that short-term symptom change was more informative than baseline patient characteristics in estimating eventual outcome.
  6. Cost may influence SSRI selection in routine practice, as the mean per month cost was 1,284 Indian rupees (US$ 17.22) for sertraline versus 2,790 Indian rupees (US$ 37.41) for fluvoxamine despite similar tolerability profiles.
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Physicians Postgraduate Press, Inc. (PPP) makes no warranties about the accuracy or completeness of any information published in The Journal of Clinical Psychiatry or other PPP materials, and disclaims liability for any use or non-use of that information. Clinicians should not rely solely on these materials and should exercise their own professional judgment when making patient care decisions on an individualized basis.

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