Abstract
Levent Sevincok, Associate Professor; Bulent Uygur, Research Assistant, Department of Psychiatry, Adnan Menderes University Faculty of Medicine, Aydin, Turkey:
Anecdotal evidence suggests that venlafaxine might be effective in the treatment of patients with Obsessive– Compulsive Disorder (OCD) [1, 2, 3]. The purpose of this study was to assess the efficacy of moderate doses of venlafaxine in an open-label study of 12 patients with OCD.
Twelve patients (10 women, 2 men; mean ± SD age = 29.7 ± 10.6 years; range, 18–48) who had a baseline Yale-Brown Obsessive Compulsive Scale (YBOCS) [4] total score of 16 or greater, were treated with daily doses of venlafaxine, ranging from 150 to 225 mg in an 8-week, open-label trial. Target symptoms were rated at regular intervals with YBOCS; Hamilton Rating Scale for Depression (HRSD) [5] and Clinical Global Impression Scale (CGI) [6]. Symptom change was measured using an analysis of variance for repeated measures (ANOVA).
The mean ± SD duration of OCD was 6.0 ± 4.9 years. The mean (± SD) daily dose of medication was 210.0 ± 31.6. There were no dropouts. Nine patients (75%) were judged responders based on ≥ 35% decrease in YBOCS, whereas six patients (50%) were judged responders based on CGI scale scores of 1 or 2. The mean OCD scores declined for the group between baseline and week eight, with statistically significant changes seen in the YBOCS (26.18 ± 3.37 vs 15.45 ± 6.1, F = 35.34, p = 0.000). Statistically significant differences were first observed by week four (baseline vs week four, F-test:10.49, p = 0.009) and increased until the end of treatment. Hamilton Rating Scale for Depression ratings showed a significant change at the end of the study, declining from 13.54 ± 7.34 to 3.0 ± 2.19 (F = 30.53, p = 0.000).
Antidepressants are effective in the acute treatment of OCD at higher doses than those used to treat depression. We found that antidepressant doses of venlafaxine might be effective in acute treatment of OCD. In our study, the improvement observed was significant by the fourth week of treatment and increased until the end of the trial. However, double-blind placebo-controlled trials with different doses of at least 12 week's duration, are required before a clear judgement of efficacy can be made.