Drug treatment of obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) traditionally has been considered a rare, treatment refractory disorder of psychological origin. However, OCD appears to be much more common than was previously believed. Moreover, in recent years controlled studies demonstrated that clomipramine is more effective than placebo and than other tricyclics for reducing obsessive-compulsive symptoms. Although it has been suggested that clomipramine was effective in treating obsessive-compulsive symptoms by an antidepressant mechanism, the majority of the controlled studies found that its antiobsessional effects occurred whether the patient was depressed or not. The apparent specificity of clomipramine, and, to some extent, newer serotonin selective antidepressants, suggests a serotonergic role in the psychobiology of OCD.