Intravenous Clomipramine in Severe and Refractory Obsessive-Compulsive Disorder

Cordioli, Aristides Volpato; Sousa, Marcelo Basso de; Bochi, Daniela Braga

doi:10.1097/01.jcp.0000095353.32154.a8

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…antidepressants were used to treat OCD. They included two case reports (Warneke, 1985;Thakur, et al, 1991) and eight case series or open trials (Capstick, 1971(Capstick, , 1975Warneke, 1984Warneke, , 1989Fallon, et al, 1992;Koran, et al, 1994;Pallanti, et al, 2002;Cordioli, et al, 2003). There were also four comparative trials reported, one of which was placebo-controlled (Koran, et al, 1997(Koran, et al, , 1998(Koran, et al, , 2006Fallon, et al, 1998).…”

Section: Resultsmentioning

confidence: 99%

“…Most recently, Cordioli, et al (2003) reported on a case series of six patients suffering from severe (as measured by a score of >30 on the Y-BOCS) OCD who were all refractory to treatment, which included previous trials of oral CMI. The patients were initially treated with 14 daily infusions of CMI, up to a maximum dose of 250 mg daily, and subsequently received oral CMI for further 10 weeks, prescribed at their maximum tolerated i.v.…”

Section: Clomipraminementioning

confidence: 99%

“…Evidence from the multiple case series and trials reviewed in this article suggests that even gradual i.v. titration seems to offer an outcome advantage over gradual oral dosing of active agent (Capstick, 1971(Capstick, , 1975Warneke, 1984Warneke, , 1989Fallon, et al, 1992;Koran, et al, 1994;Pallanti, et al, 2002;Cordioli, et al, 2003) or placebo (Fallon, et al, 1998). Although an open trial, i.v.…”

Section: Onset Of Improvementmentioning

confidence: 99%

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Review: Intravenous anti-obsessive agents: a review

Ravindran¹,

Jung

2008

J Psychopharmacol

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Oral antidepressants are currently the first-line pharmacotherapy for obsessive-compulsive disorder (OCD), but response rates can often be low and with delayed onset of therapeutic action. Some reports have suggested that intravenous (i.v.) anti-obsessive agents may have faster onset of action and greater efficacy. A Medline search was conducted for all reports pertaining to the use of i.v. antidepressants for OCD. Search terms included: 'intravenous', 'clomipramine', 'selective serotonin reuptake inhibitor', 'tricyclic', 'citalopram', 'sertraline', 'paroxetine', 'fluvoxamine', 'SSRIs' and 'intravenous antidepressants'. Relevant articles mainly investigated clomipramine (CMI) with one open trial examining citalopram. Intravenous agents appear to be well-tolerated, particularly in those who have failed oral agents, and may act more rapidly to produce initial clinical response, although this advantage is often lost over time. Preliminary evidence suggests subgroups of patients with severe treatment-refractory OCD may benefit from i.v. anti-obsessive agents, CMI and citalopram. Larger, controlled trials are needed for more definitive conclusions.

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Section: Resultsmentioning

confidence: 99%

Section: Clomipraminementioning

confidence: 99%

Section: Onset Of Improvementmentioning

confidence: 99%

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Review: Intravenous anti-obsessive agents: a review

Ravindran¹,

Jung

2008

J Psychopharmacol

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“…Intravenous (IV) CMI has been studied in adults, on an investigational basis, typically in inpatients with severe OCD not responsive to multiple prior medication trials, including oral CMI 82–84. IV CMI may be better tolerated than the oral form and it provides 4- to 14-fold higher peak plasma concentrations 83.…”

Section: Medication Treatment Of Ocdmentioning

confidence: 99%

Psychotherapy and medication management strategies for obsessive-compulsive disorder

Walsh¹,

McDougle²

2011

NDT

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Obsessive-compulsive disorder (OCD) is a chronic anxiety disorder. While medication and psychotherapy advances have been very helpful to patients, many patients do not respond adequately to initial trials of serotonergic medication or cognitive-behavioral therapy (CBT) and require multiple treatment trials or combination therapies. Comorbidity may also influence treatment response. The role of streptococcal infections in pediatric OCD has become an area of intense scrutiny and controversy. In this article, current treatment methods for OCD will be reviewed, with special attention to strategies for treating OCD in children and in patients with comorbid tic disorders. Alternative psychotherapy strategies for patients who are highly anxious about starting CBT, such as cognitive therapy or augmentation with D-cycloserine, will be reviewed. Newer issues regarding use of antibiotics, neuroleptics, and glutamate modulators in OCD treatment will also be explored.

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Treatment of anxiety: current status and controversial issues

Rodríguez¹,

Simpson²

2010

Anxiety Disorders

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Intravenous Clomipramine in Severe and Refractory Obsessive-Compulsive Disorder

Cited by 3 publications

References 8 publications

Review: Intravenous anti-obsessive agents: a review

Review: Intravenous anti-obsessive agents: a review

Psychotherapy and medication management strategies for obsessive-compulsive disorder

Treatment of anxiety: current status and controversial issues

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