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Switching from serotonin reuptake inhibitors to duloxetine in patients with resistant obsessive compulsive disorder: a case series

¹ Department of Psychiatry, Department of Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy; and Department of Psychiatry, Compulsive, Impulsive and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USA.
² Department of Psychiatry, Department of Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy.
³ Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Italy.
⁴ Department of Psychiatry, Department of Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy

^* To whom correspondence should be addressed.

	Abstract

Obsessive compulsive disorder (OCD) is a chronic disorder, currently recognized as one of the most common psychiatric disorder as well as one of the most disabling of all medical disorders. OCD is characterized by high rates of partial and/or absent response to standard, recommended treatments (serotonin reuptake inhibitors and psychotherapy). Recent investigation showed that Venlafaxine, a dual serotonin and norepinephrine reuptake inhibitor (SNRI), may be a valid alternative for some treatment-refractory patients. We present the cases of four OCD patients with comorbid mood or anxiety disorders, who were treated with serotonin reuptake inhibitors (SRIs) at adequate doses for at least 12 weeks, showing partial/no response. Patients were then switched to Duloxetine up to 120mg/day and followed up for 12 weeks. Three out of four patients showed a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score reduction _35%. Duloxetine may be helpful in patients with treatment-resistant OCD, although larger and controlled studies are warranted to confirm this preliminary observation.

Key Words: obsessive compulsive disorder (OCD), treatment-resistance, serotonin and norepinephrine reuptake inhibitors (SNRIs), Duloxetine

First published on January 21, 2008, doi:10.1177/0269881107079865

Journal of Psychopharmacology 2008;22:210.

A more recent version of this article appeared on March 1, 2008


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