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J Clin Pharm Ther. 1998 Apr;23(2):155-9.

Combination of clomipramine and nortriptyline in the treatment of obsessive-compulsive disorder: a double-blind, placebo-controlled trial.

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  • 1Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Iran.



There is growing interest in investigating noradrenergic functions in obsessive-compulsive disorder (OCD) because some antidepressants with strong effects on serotonin reuptake blockade fail to relieve obsessive-compulsive symptoms. We undertook a trial to investigate whether the combination of clomipramine with nortriptyline was more effective than clomipramine alone.


Thirty patients who met the DSM-IV criteria for OCD completed the study. Patients were allocated in a random fashion, 15 each to clomipramine 150 mg/ day plus nortriptyline 50 mg/day and clomipramine 150 mg/day plus placebo.


Although both protocols significantly decreased the scores of the Yale-Brown obsessive-compulsive scale over the trial period, the combination of clomipramine and nortriptyline showed a significant superiority over clomipramine alone in the treatment of OCD.


As this study indicates, a rapid onset of action is one of the advantages of this combination. This study supports further investigation of the noradrenergic-serotonergic hypothesis in OCD.

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