International prescribing practices in obsessive-compulsive disorder (OCD)

Brakoulias, Vlasios; Starčević, Vladan; Belloch, Amparo; Dell’Osso, Liliana; Ferrão, Ygor Arzeno; Fontenelle, Leonardo F.; Löchner, Christine; Marazziti, Donatella; Martin, Andrew; Matsunaga, Hisato; Miguel, Eurí­pedes Constantino; Reddy, Y.C. Janardhan; Rosário, Maria Conceição do; Shavitt, Roseli Gedanke; Sundar, A Shyam; Stein, Dan J.; Viswasam, Kirupamani

doi:10.1002/hup.2541

Cited by 25 publications

(26 citation statements)

References 28 publications

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“…In accordance with OCD treatment guidelines, a majority of participants reported taking SSRIs (53.3%; n = 3,910). Despite fluoxetine being the most frequently used SSRI, there was significant variation between sites and this is consistent with previous studies (Brakoulias et al, ; Van Ameringen et al, ). It is difficult to explain why sertraline was more commonly used in China or why paroxetine was more commonly used in Japan.…”

Section: Discussionsupporting

confidence: 91%

“…Among other pharmacological agents, this study repeated the findings of the previous survey (Brakoulias et al, ) in regard to benzodiazepines. The use of benzodiazepines in approximately 15% of patients suggests that benzodiazepines have a therapeutic role for some patients with OCD.…”

Section: Discussionsupporting

confidence: 82%

“…Cross‐cultural studies of OCD have been encouraged (Stein & Rapoport, ), and research assessing international prescribing trends for OCD can inform us whether treatment preferences vary from one country to another. Building on the findings of a previous international survey (Brakoulias et al, ), this study thus had three aims: (a) to compare the frequencies of psychotropic agent use for OCD across a larger number of countries, with a more specific focus on the types of SSRIs and antipsychotics and other pharmacological agents used in each country, (b) to report on the use of novel therapeutic modalities, for example, transcranial magnetic stimulation (TMS), in OCD, and (c) to determine the frequency of use of ERP in OCD and its accessibility. Based on existing literature, study hypotheses were as follows: (a) Use of pharmacological agents for OCD varies significantly between countries (Brakoulias et al, ; Van Ameringen et al, ), (b) SSRIs are the most commonly prescribed pharmacotherapeutic agents for OCD (Brakoulias et al, ; Brakoulias et al, ), and (c) ERP is used less frequently in countries where access to trained therapists is limited and costly.…”

Section: Introductionmentioning

confidence: 99%

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Treatments used for obsessive–compulsive disorder—An international perspective

Brakoulias

Starčević

Albert

et al. 2019

Human Psychopharmacology

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Objective The objective of this study was to characterise international trends in the use of psychotropic medication, psychological therapies, and novel therapies used to treat obsessive–compulsive disorder (OCD). Methods Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their samples. Consistency of summary statistics across countries was evaluated. Results The study surveyed 19 expert centres from 15 countries (Argentina, Australia, Brazil, China, Germany, Greece, India, Italy, Japan, Mexico, Portugal, South Africa, Spain, the United Kingdom, and the United States) providing a total sample of 7,340 participants. Fluoxetine (n = 972; 13.2%) and fluvoxamine (n = 913; 12.4%) were the most commonly used selective serotonin reuptake inhibitor medications. Risperidone (n = 428; 7.3%) and aripiprazole (n = 415; 7.1%) were the most commonly used antipsychotic agents. Neurostimulation techniques such as transcranial magnetic stimulation, deep brain stimulation, gamma knife surgery, and psychosurgery were used in less than 1% of the sample. There was significant variation in the use and accessibility of exposure and response prevention for OCD. Conclusions The variation between countries in treatments used for OCD needs further evaluation. Exposure and response prevention is not used as frequently as guidelines suggest and appears difficult to access in most countries. Updated treatment guidelines are recommended.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Treatments used for obsessive–compulsive disorder—An international perspective

Brakoulias

Starčević

Albert

et al. 2019

Human Psychopharmacology

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“…SSRIs were used by 61.4% (n=145) of the U.S. group and 39.2% (n=373) of the Brazilian group (x 2 = 37.951; p < .001), while atypical antipsychotics were taken by 13.6% (n=35) of the U.S. participants and 7.8% (n=74) of the Brazilian subjects (x 2 = 11.266; p = .001). Previous research approaching medication status had been published using samples that significantly overlap with ours [see Mancebo and colleagues (2006) for the U.S. group (Mancebo et al, 2006), and Brakoulias and collaborators (2016) for the Brazilian sample (Brakoulias et al, 2016)].…”

Section: Resultsmentioning

confidence: 91%

A cross-cultural clinical comparison between subjects with obsessive-compulsive disorder from the United States and Brazil

Medeiros

Torres

Boisseau

et al. 2017

Psychiatry Research

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Although OCD is a global problem, the literature comparing, in a direct and standardized way, the manifestations across countries is scarce. Therefore, questions remain as to whether some important clinical findings are replicable worldwide, especially in the developing world. The objective of this study was to perform a clinical comparison of OCD patients recruited in the United States (U.S.) and Brazil. Our sample consisted of 1,187 adult, treatment-seeking OCD outpatients from the U.S. (n=236) and Brazil (n=951). With regards to the demographics, U.S. participants with OCD were older, more likely to identify themselves as Caucasian, had achieved a higher educational level and were less likely to be partnered when compared to Brazilians. Concerning the clinical variables, after controlling for demographics the two samples presented largely similar profiles. Brazilian participants with OCD, however, endorsed significantly greater rates of generalized anxiety disorder and post-traumatic stress disorder, whereas U.S. subjects were significantly more likely to endorse a lifetime history of addiction (alcohol-use and substance-use disorders). This is the largest direct cross-cultural comparison to date in the OCD field. Our results provide much needed insight regarding the development of culture-sensitive treatments.

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“…Benzodiazepines have been traditionally viewed as ineffective for OCD symptoms. They are however commonly used in OCD [14] and yet studies are limited in regards to when they are used and what symptoms they may be effective for. Similarly, studies of SSRI augmentation with glutamatergic agents such as riluzide, memantine, D-cycloserine, and N-acetylcysteine are limited by small numbers.…”

Section: Predictors Of Response To Other Psychotropic Agentsmentioning

confidence: 99%