Fluvoxamine and other selective serotonin reuptake inhibitors (SSRIs) have been shown to be effective for the treatment of OCD in numerous controlled studies.2 Clomipramine, a tricyclic antidepressant, is considered to be slightly more effective for OCD than the SSRIs. However, the SSRIs have fewer side effects and are better tolerated by patients than clomipramine. Therefore, many experts recommend that a SSRI be tried first.2,3 Buspirone, risperidone, and haloperidol may be considered as augmentation strategies for selected patients but are not appropriate as first-line treatment.
2. Hollander E, Simeon D. Anxiety disorders. In: Hales RE, Yudofsky, editors. Textbook of clinical psychiatry. Washington (DC): American Psychiatric Publishing; 2003:543-630.
3. Janicak PG, Davis JM, Preskorn SH, Ayd FJ. Assessment and treatment of other disorders. In: Principles and practice of psychopharmacotherapy. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001:523-58.
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