Specificity of Serotonin Reuptake Inhibitors in the Treatment of Obsessive-Compulsive Disorder: Comparison of Fluvoxamine and Desipramine

Wayne K. Goodman, Lawrence H. Price, Pedro L. Delgado, Joseph Palumbo, John H. Krystal, Linda M. Nagy, Steven A. Rasmussen, George R. Heninger, Dennis S. Charney

Research output: Contribution to journalArticle

299 Scopus citations

Abstract

To evaluate whether serotonin reuptake inhibition is critical to the treatment of obsessive-compulsive disorder, 40 outpatients with a principal diagnosis of obsessive-compulsive disorder were randomized in a double-blind fashion to 8 weeks of treatment with either the serotonin reuptake inhibitor fluvoxamine maleate (n = 21) or the norepinephrine reuptake inhibitor desipramine hydrochloride (n =19). Fluvoxamine was significantly better than desipramine in reducing the severity of obsessive-compulsive symptoms, as measured by the Yale-Brown Obsessive Compulsive Scale and by the global response rate (“responder” equaling “much improved”). Eleven of 21 patients were responders with fluvoxamine compared with 2 of 19 patients with desipramine. Fluvoxamine, but not desipramine, was also effective in reducing the severity of “secondary” depression. Fluvoxamine-induced improvement in symptoms of obsessive-compulsive disorder was not correlated with the severity of baseline depressive symptoms. This study provides additional evidence that the acute serotonin reuptake properties of a drug are predictive of its anti—obsessive-compulsive efficacy. It is hypothesized that the mechanism of action of serotonin reuptake inhibitors in obsessive-compulsive disorder may be related to chronic treatment-induced adaptive changes in presynaptic serotonin receptor function (eg, autoreceptor desensitization) and/ or indirect influences on dopaminergic function (eg, in the basal ganglia).

Original languageEnglish (US)
Pages (from-to)577-585
Number of pages9
JournalArchives of General Psychiatry
Volume47
Issue number6
DOIs
StatePublished - Jun 1990

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Specificity of Serotonin Reuptake Inhibitors in the Treatment of Obsessive-Compulsive Disorder: Comparison of Fluvoxamine and Desipramine'. Together they form a unique fingerprint.

  • Cite this

    Goodman, W. K., Price, L. H., Delgado, P. L., Palumbo, J., Krystal, J. H., Nagy, L. M., Rasmussen, S. A., Heninger, G. R., & Charney, D. S. (1990). Specificity of Serotonin Reuptake Inhibitors in the Treatment of Obsessive-Compulsive Disorder: Comparison of Fluvoxamine and Desipramine. Archives of General Psychiatry, 47(6), 577-585. https://doi.org/10.1001/archpsyc.1990.01810180077011