Tuesday 01 December 2009, 12:00AM
PEARLS 129, June 2008, written by Brian R
McAvoy
Clinical question
How effective are selective serotonin re-uptake inhibitors (SSRIs)
for obsessive compulsive disorder (OCD) in adults?
Bottom line
Compared to placebo, SSRIs are more effective for OCD in adults,
at least in the short term (up to 3 months). People receiving SSRIs
are nearly twice as likely as those receiving placebo to achieve
clinical response (defined as 25% or greater reduction in
symptoms). In a group of patients where 10% might be expected to
recover even without treatment, the NNT*=12, whereas in a group
where 20% might be expected to recover even without treatment, the
NNT=6. SSRIs included in the studies included citalopram,
fluoxetine, fluvoxamine, paroxetine and sertraline. *NNT = number
needed to treat to benefit 1 individual.
Caveat
Indirect comparisons of effectiveness suggested, although
individual SSRIs were similar in their effectiveness, they differed
in terms of their adverse effects, the commonest one overall being
nausea.
Context
OCD is a common and disabling disorder, which frequently follows a
chronic course. It has a lifetime prevalence of 2.2% in New
Zealand.1
Cochrane Systematic Review
Soomro GM et al. Selective serotonin re-uptake inhibitors (SSRIs)
versus placebo for obsessive compulsive disorder (OCD). Cochrane
Reviews 2008, Issue 1. Article No. CD001765. DOI:
10.1002/14651858.CD001765. This review contains 17 trials involving
3097 participants.
Further reference
1. Bebbington PE. Br J Psychiatry 1998;35:2-6.