Treating OCD: what to do when first-line therapies fail
David Castle, Peter Bosanac, Susan Rossell
AUSTRALASIAN PSYCHIATRY | SAGE PUBLICATIONS LTD | Published : 2015
OBJECTIVE: To provide a clinically-focused review of the biological treatment of treatment-resistant obsessive compulsive disorder (OCD). CONCLUSIONS: There is a paucity of research on how to manage OCD patients who fail to respond adequately to first line therapies. High-dose selective serotonin reuptake inhibitors (SSRIs) and clomipramine have good evidence-based data. Combinations of SSRIs have little support in clinical trials, but the combination of SSRIs and clomipramine can be helpful: careful clinical and cardiac monitoring is required. Certain adjunctive antipsychotics have a reasonable evidence base in OCD, but their use also needs to be weighed against the potential side effect bu..View full abstract
David Castle has received grant monies for research from Eli Lilly, Janssen Cilag, Roche, Allergen, Bristol-Myers Squibb, Pfizer, Lundbeck, Astra Zeneca and Hospira; Travel Support and Honoraria for Talks and Consultancy from Eli Lilly, Bristol-Myers Squibb, Astra Zeneca, Lundbeck, Janssen Cilag, Pfizer, Organon, Sanofi-Aventis, Wyeth, Hospira and Servier; and is a current Advisory Board Member for Lu AA21004 (Lundbeck); Varenicline (Pfizer); Asenapine (Lundbeck); Bitopertin (Roche); Aripiprazole LAI (Lundbeck); and Lisdexamfetamine (Shire). He has no stocks nor shares in any pharmaceutical company.