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Acta Psychiatr Scand. 2005 Apr;111(4):261-71.

Obsessive-compulsive disorder: a critical review of therapeutic perspectives.

Author information

1
Academic Anxiety Center, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands. koen.schruers@pn.unimaas.nl

Abstract

OBJECTIVE:

Obsessive-compulsive disorder (OCD) is a chronic disabling disease with profound implications for social functioning. Thirty per cent of all patients with OCD show insufficient improvement with state-of-the-art treatment. Conventional treatment and alternative treatment options for this population were investigated.

METHOD:

A selective review of the relevant scientific literature on OCD treatment and treatment resistance was conducted.

RESULTS:

In addition to serotonin reuptake inhibitors (SRIs) and cognitive-behavioural therapy, alternative monotherapies, SRI augmentation strategies with a variety of drugs and electroconvulsive therapy have shown results in individual cases, but no conclusive evidence has been found in placebo-controlled trials. While studies investigating neurosurgery for refractory OCD show positive results, most of these studies have methodological shortcomings.

CONCLUSION:

Novel approaches currently under investigation that have shown promising effects for treatment-resistant OCD include SRI augmentation with atypical antipsychotics and chronic deep brain stimulation, a new surgical technique. Placebo-controlled trials for both treatment options will be needed to confirm preliminary findings.

[Indexed for MEDLINE]

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