D. Vasile 1, O. Vasiliu 2, A. G. Mangalagiu 2, Diana Gabriela Ojog 1
1 University of Medicine and Pharmacy “Carol Davila,” Bucharest
2 Military Emergency Universitary Hospital “Dr. Carol Davila” Bucharest, Department of Psychiatry
Abstract
The efficacy of selective serotonin reuptake inhibitors (SSRIs) in the treatment of obsessivecompulsive disorder (OCD) has some important limitations, as almost half of these patients are nonresponders. Therefore, an increasing number of pharmacological augmentation strategies have been developed in order to cope with SSRIs non-responders: increasing dosages to the maximum tolerated level, antidepressants switch, augmentation with pharmacologic agents or psychotherapy, alternative ways of treatment administration etc. In this systematic review we evaluated studies which focused upon the efficacy of the pharmacologic augmentation strategies in SSRIs resistant cases of OCD. Atypical and typical antipsychotics, antidepressants and other agents such as beta-blockers, psychostimulants or omega 3 fatty acids were detected in clinical studies and included in our review. The most supported strategies are typical antipsychotics (especially haloperidol), atypical antipsychotics (mainly risperidone), antidepressants like clomipramine or trazodone and the beta-blocker pindolol. More research is needed in order to evaluate the efficacy of other pharmacologic agents, such as newer antipsychotics and antidepressants, mood-stabilizers and various serotoninergic agents.