Pharmacological treatment strategies in obsessive compulsive disorder: A cross-sectional view in nine international OCD centers

Ameringen, Michael Van; Simpson, W. Sparrow; Patterson, Beth; Dell’Osso, Bernardo; Fineberg, Naomi; Hollander, Eric; Hranov, Luchezar; Hranov, Georgi; Löchner, Christine; Karamustafalıoğlu, Oğuz; Marazziti, Donatella; Menchón, José M.; Nicolini, Humberto; Pallanti, Stefano; Stein, Dan J.; Zohar, Joseph

doi:10.1177/0269881113517955

Cited by 55 publications

(42 citation statements)

References 47 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%

“…Atypical antipsychotics were used commonly (23.3%), which is likely to reflect the resistant nature of OCD patients who may have seen several clinicians before coming to a specialised OCD clinic. This finding is similar to the results of a multisite study (Van Ameringen et al, ), reporting that 30% of patients with OCD received augmentation with atypical antipsychotics. The preference for risperidone and aripiprazole as augmenting agents may relate to their relatively favourable side effect profiles and the greater number of reported trials using these agents (Albert et al, ; Veale et al, ).…”

Section: Discussionsupporting

confidence: 90%

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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: 90%

Treatments used for obsessive–compulsive disorder—An international perspective

Brakoulias

Starčević

Albert

et al. 2019

Human Psychopharmacology

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“…Well over one-third (38.4%) of individuals with OCD in this large Brazilian sample were treated with BDZs at some stage of their illness. This is higher than the previously reported rates of BDZ use in OCD, which ranged from 24.9% to 35.5% (Blanco et al, 2006;Patel et al, 2014;Van Ameringen et al, 2014). A possible reason for the higher rate reported in this study is that we combined current and past BDZ use, whereas other studies did not assess past BDZ use.…”

Section: Discussioncontrasting

confidence: 85%

“…These findings suggest that BDZs are more likely to be used when OCD is more complex or more difficult to manage, prompting clinicians to try various pharmacological agents. Similar polypharmacy in OCD has been reported by others (Blanco et al, 2006;Van Ameringen et al, 2014). The present study sheds more light on this issue by suggesting that BDZs may often be used as part of various augmentation strategies.…”

supporting

confidence: 89%

Use of benzodiazepines in obsessive–compulsive disorder

Starčević

Berle

Rosario

et al. 2016

International Clinical Psychopharmacology

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Objectives: This study aimed to determine the frequency of benzodiazepine (BDZ) use in a large sample of patients with obsessive-compulsive disorder (OCD) and ascertain the type of BDZ used and the correlates and predictors of BDZ use in OCD. Conclusions: This is the first study to comprehensively examine BDZ use in OCD subjects, demonstrating that it is relatively common, despite recommendations from treatment guidelines. Use of BDZs in combination with several other medications over time and in patients with marked anxiety suggests that OCD patients taking BDZs may be more complex and more difficult to manage. This calls for further research and clarification of the role of BDZs in the treatment of OCD. Methods

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“…91,107 Moreover, antipsychotics are the most often prescribed augmentation drugs in international OCD centers. 119 This method may be chosen in the pregnancy period. Nevertheless, there is no adequate data on safety of a combination between antidepressants and antipsychotics during pregnancy.…”

Section: Second-line Haloperidolmentioning

confidence: 99%

Pharmacotherapy of obsessive-compulsive disorder during pregnancy: a clinical approach

Uğuz

2015

Rev. Bras. Psiquiatr.

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Obsessive-compulsive disorder (OCD) is a relatively common psychiatric disorder in the perinatal period. However, specific pharmacological treatment approaches for patients with OCD during pregnancy have not been satisfactorily discussed in the literature. In addition, there are no randomized controlled studies on the treatment of this disorder during pregnancy. The present paper discusses the pharmacological treatment of OCD in the light of data on the safety of antipsychotics and serotonergic antidepressants during pregnancy and their efficacy in the non-perinatal period. Treatment decisions should be individualized because the risk-benefit profile of pharmacotherapy is an important issue in the treatment of pregnant women with any psychiatric diagnosis.

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Pharmacological treatment strategies in obsessive compulsive disorder: A cross-sectional view in nine international OCD centers

Cited by 55 publications

References 47 publications

Treatments used for obsessive–compulsive disorder—An international perspective

Treatments used for obsessive–compulsive disorder—An international perspective

Use of benzodiazepines in obsessive–compulsive disorder

Pharmacotherapy of obsessive-compulsive disorder during pregnancy: a clinical approach

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