PHARMACOLOGICAL TREATMENT OF OBSESSIVE-COMPULSIVE DISORDER: CURRENT APPROACHES
DOI:
https://doi.org/10.56238/levv16n51-078Keywords:
Obsessive-compulsive Disorder, Pharmacological Treatment, Selective Serotonin Reuptake Inhibitors, Adjuvant TherapiesAbstract
Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric condition characterized by obsessions and compulsions that severely impact individuals' quality of life. Pharmacological treatment, along with psychotherapeutic interventions, constitutes the fundamental pillar of the therapeutic approach. Cognitive-behavioral therapy (CBT) stands out as the first-line psychotherapeutic treatment for obsessive-compulsive disorder (OCD), due to its robust and well-established theoretical and empirical basis. (Shely Frazão) This article critically reviews the main current pharmacological strategies, discussing the efficacy of selective serotonin reuptake inhibitors (SSRIs), the role of clomipramine, and alternatives in resistant cases. In light of recent evidence, the integration of glutamatergic system modulator agents, 5-HT3 antagonists, and atypical antipsychotics as augmentation strategies stands out, as well as new evidence for non-invasive neuromodulation and intensive cognitive-behavioral therapy.
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References
CERVIN, Matti. Obsessive-compulsive disorder: Diagnosis, clinical features, nosology, and epidemiology. Psychiatric Clinics of North America, 2022. DOI: https://doi.org/10.1016/j.psc.2022.10.006
CORRELL, C. et al. Second-generation antipsychotics in obsessive-compulsive disorder: efficacy and tolerability. Comprehensive Psychiatry, 2022.
FINEBERG, N. A. et al. Clinical advances in obsessive-compulsive disorder: a position statement by the international college of obsessive-compulsive spectrum disorders. International Clinical Psychopharmacology, v. 35, p. 173-193, May 2020. DOI: 10.1097/yic.0000000000000314. DOI: https://doi.org/10.1097/YIC.0000000000000314
GOODMAN, Wayne K.; STORCH, Eric A.; SHETH, Sameer A. Harmonizing the Neurobiology and Treatment of Obsessive-Compulsive Disorder. The American Journal of Psychiatry, v. 178, n. 1, p. 17–29, 1 jan. 2021. DOI: https://doi.org/10.1176/appi.ajp.2020.20111601
HOLM, Lena Engelund; JANSSON, Lennart; NORDGAARD, Julie. [Differential diagnosis in obsessive-compulsive disorder]. Ugeskrift for Laeger, v. 182, n. 48, p. V03200167, 23 nov. 2020.
KAYSER, Reilly R. Pharmacotherapy for Treatment-Resistant Obsessive-Compulsive Disorder. The Journal of Clinical Psychiatry, v. 81, n. 5, p. 19ac13182, 8 set. 2020. DOI: https://doi.org/10.4088/JCP.19ac13182
LI, T. et al. Treatment strategies for serotonin reuptake inhibitor-resistant obsessive-compulsive disorder: a network meta-analysis of randomized controlled trials. World Journal of Biological Psychiatry, 2023.
MAITI, R. et al. Pharmacological augmentation of serotonin reuptake inhibitors in patients with obsessive-compulsive disorder: systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 2023. DOI: https://doi.org/10.1111/acps.13568
SHAH, A. et al. 5-HT3 antagonists as adjunctive therapy for obsessive-compulsive disorder: systematic review and meta-analysis. Scientific Reports, 2023.
SPENCER, Samuel D. et al. Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder. The Psychiatric Clinics of North America, v. 46, n. 1, p. 167–180, mar. 2023. DOI: https://doi.org/10.1016/j.psc.2022.10.004
ZHANG, Y. et al. Glutamate modulators in obsessive-compulsive disorder: a systematic review. Psychiatry Research, 2022.
