Medication

(ref 174)

• Drug treatment might be indicated where patients are unwilling to engage in behaviour or cognitive therapy, or where expertise to deliver such therapies is not available.
• Clomipramine and SSRIs (eg fluoxetine, fluvoxamine, sertraline and citalopram) are effective in the treatment of OCD. An adequate trial of treatment usually requires moderate to maximum BNF dose and a duration of about 12 weeks (ref 179) (BNF 4.3.1 and 4.3.3).
• Discontinuation of drug after improvement often results in relapse within weeks so long-term maintenance treatment with medication may be required (ref 179).

References

174 NICE will publish a guideline on the management of Obsessive-compulsive disorder in February 2005.

179 Marks IM. Fears, Phobias and Rituals. New York: Oxford University Press, 1987.

Last edited: 26/1/2004

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