Evidence For Drug Treatments

There is evidence that serotonin reuptake inhibitors (SRIs) are more effective than placebo (Abramowitz, 1997; Goodman et al., 1990; Kobak et al., 1998; Piccinelli et al., 1995) and more effective than other kinds of antidepressants (Hoehn-Saric et al., 2000; Picinelli et al., 1995) in reducing OCD symptoms in clinical trials. The evidence suggests that different serotonin reuptake inhibitors have similar efficacy (Kobak et al., 1998; Picinelli et al., 1995) but clomipramine has a higher rate of adverse effects than selective serotonin reuptake inhibitors (Jenike, 1998). Unfortunately most drug studies assess response only over a short period. One prospective study showed that sertraline produced further significant improvement in a 40-week open label extension of a RCT (Rasmussen et al., 1997). Over 50 % of patients respond to serotonin reuptake inhibitors (Erzegovesi et al., 2001; Ravizza et al., 1995) but there is evidence of a rapid return of symptoms in most treatment responders following discontinuation of medication (Pato et al., 1988). Sixteen responders out of 18 had a substantial recurrence by the end of week seven following discontinuation.

Three small RCTs have demonstrated that adding an antipsychotic when people have failed to respond to an SRI improves the response rate compared to addition of placebo (Atmaca et al., 2002; McDougle et al., 1994, 2000).

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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