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Clomipramine Treatment of Obsessive-Compulsive Disorder: I. A Controlled Clinical Trial

Clomipramine Treatment of Obsessive-Compulsive Disorder: I. A Controlled Clinical Trial Abstract • The effect of clomipramine hydrochloride in severe obsessive-compulsive disorder (OCD) was compared with that of nortriptyline hydrochloride and placebo in a five-week randomized, double-blind trial. Clomipramine, but not nortriptyline, was superior to placebo in interview-based ratings of severity of OCD. The effect was not clear-cut until after five weeks of treatment. When clomipramine was given openly to 22 patients after the end of the controlled trial, half of the patients responded to the drug. The response could not be predicted from severity or duration of illness, sex or age of the patient, or presence or absence of secondary depressive symptoms. The amelioration with clomipramine was not sustained if the drug was withdrawn. References 1. Goodwin DW, Guze SB, Robins E: Follow-up studies in obsessional neurosis . Arch Gen Psychiatry 20:182-187, 1969.Crossref 2. Freed A, Kerr TA, Roth M: The treatment of obsessional neurosis . Br J Psychiatry 120:590-591, 1972.Crossref 3. Fernandez Cordoba E, Lopez-Ibor Alino J: La monochlorimipramina en enfermos psiquiatricors resistentes a otros tratamientos . Actas Luso Esp Neurol Psiquiatr 26:119-147, 1967. 4. Capstick N: Chlorimipramine in obsessional states . Psychosomatics 12:332-335, 1971.Crossref 5. Ananth J: Treatment of obsessive-compulsive neurosis with clomipramine (Anafrani) . J Int Med Res 5( (suppl 5) ):38-41, 1977. 6. Carlsson A, Corrodi H, Fuxe K, et al: Effect of antidepressant drugs on the depletion of intraneuronal brain 5-hydroxytryptamine stores caused by 4-methyl-alpha-metatyramine . Eur J Pharmacol 5:357-366, 1969.Crossref 7. Hamberger B, Tuck JR: Effect of tricyclic antidepressants on the uptake of noradrenaline and 5-hydroxytryptamine by rat brain slices incubated in buffer or human plasma . Eur J Clin Pharmacol 5:229-235, 1973.Crossref 8. Bertilsson L, Åsberg M, Thorén P: Differential effect of clomipramine and nortriptyline on cerebrospinal fluid metabolites of serotonin and noradrenaline in depression . Eur J Clin Pharmacol 7:365-368, 1974.Crossref 9. Åsberg M, Ringberger VA, Sjöqvist F, et al: Monoamine metabolites in the cerebrospinal fluid and serotonin-uptake inhibition during treatment with chlorimipramine . Clin Pharmacol Ther 21:201-207, 1977. 10. Carlsson A: Drugs which block the storage of 5-hydroxytryptamine and related amines , in Erspamer V (ed): Handbuch der Experimentellen Pharmakologie . New York, Springer Publishing Co Inc, 1965, vol 19, pp 529-592. 11. Yaryura-Tobias JA, Bhagavan HN: L-Tryptophan in obsessive-compulsive disorders . Am J Psychiatry 134:1298-1299, 1977. 12. Carlsson A, Corrodi H, Fuxe K, et al: Effects of some antidepressant drugs on the depletion of intraneuronal brain catecholamine stores caused by 4-alpha-dimethyl-meta-tyramine . Eur J Pharmacol 5:367-373, 1969.Crossref 13. Gittleson NL: The effect of obsessions on depressive psychosis . Br J Psychiatry 112:253-259, 1966.Crossref 14. Gittleson NL: The phenomenology of obsessions in depressive psychosis . Br J Psychiatry 112:261-264, 1966.Crossref 15. Gittleson NL: Depressive psychosis in the obsessional neurotic . Br J Psychiatry 122:883-887, 1966.Crossref 16. Kendell RE, Discipio WJ: Obsessional symptoms and obsessional personality traits in patients with depressive illness . Psychol Med 1:65-72, 1970.Crossref 17. Vanggaard T: Atypical endogenous depression . Acta Psychiatr Scand ( (suppl 267) ):5-56, 1976. 18. Spitzer RL, Endicott J, Robins E: Research diagnostic criteria: Rationale and reliability . Arch Gen Psychiatry 35:773-782, 1978.Crossref 19. Mellström B, Braithwaite R: Ion-pair liquid chromatography of amitriptyline and metabolites in plasma . J Chromatogr 157:379-385, 1978.Crossref 20. Mellström B, Tybring G: Ion-pair liquid chromatography of steady-state plasma levels of chlorimipramine and demethylchlorimipramine . J Chromatogr 143:597-605, 1977.Crossref 21. Marks IM: New approaches to the treatment of obsessive-compulsive disorder . J Nerv Ment Dis 150:420-426, 1973.Crossref 22. Åsberg M, Montgomery SA, Perris C, et al: A comprehensive psychopathological rating scale . Acta Psychiatr Scand ( (suppl 271) ):5-27, 1978. 23. Cooper J: The Leyton Obsessional Inventory . Psychol Med 1:48-64, 1970.Crossref 24. Rack PH: Clomipramine (Anafranil) in the treatment of obsessional states with special reference to the Leyton Obsessional Inventory . J Int Med Res 1:397-402, 1973. 25. Allen JJ, Rack PH: Changes in obsessive-compulsive patients as measured by Leyton Inventory before and after treatment with clomipramine . Scott Med J 20:41-44, 1975. 26. Montgomery SA, Åsberg M: A new depression scale designed to be sensitive to change . Br J Psychiatry 134:382-389, 1979.Crossref 27. Anderson NH: Scales and statistics: Parametric and nonparametric . Psychol Bull 58:305-316, 1961.Crossref 28. Boneau CA: A note on measurement scales and statistical tests . Am Psychol 16:160-261, 1961.Crossref 29. Ferguson GA: Statistical Analysis in Psychology and Education . New York, McGraw-Hill Book Co, 1971, p 271. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Clomipramine Treatment of Obsessive-Compulsive Disorder: I. A Controlled Clinical Trial

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Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1980.01780240079009
Publisher site
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Abstract

Abstract • The effect of clomipramine hydrochloride in severe obsessive-compulsive disorder (OCD) was compared with that of nortriptyline hydrochloride and placebo in a five-week randomized, double-blind trial. Clomipramine, but not nortriptyline, was superior to placebo in interview-based ratings of severity of OCD. The effect was not clear-cut until after five weeks of treatment. When clomipramine was given openly to 22 patients after the end of the controlled trial, half of the patients responded to the drug. The response could not be predicted from severity or duration of illness, sex or age of the patient, or presence or absence of secondary depressive symptoms. The amelioration with clomipramine was not sustained if the drug was withdrawn. References 1. Goodwin DW, Guze SB, Robins E: Follow-up studies in obsessional neurosis . Arch Gen Psychiatry 20:182-187, 1969.Crossref 2. Freed A, Kerr TA, Roth M: The treatment of obsessional neurosis . Br J Psychiatry 120:590-591, 1972.Crossref 3. Fernandez Cordoba E, Lopez-Ibor Alino J: La monochlorimipramina en enfermos psiquiatricors resistentes a otros tratamientos . Actas Luso Esp Neurol Psiquiatr 26:119-147, 1967. 4. Capstick N: Chlorimipramine in obsessional states . Psychosomatics 12:332-335, 1971.Crossref 5. Ananth J: Treatment of obsessive-compulsive neurosis with clomipramine (Anafrani) . J Int Med Res 5( (suppl 5) ):38-41, 1977. 6. Carlsson A, Corrodi H, Fuxe K, et al: Effect of antidepressant drugs on the depletion of intraneuronal brain 5-hydroxytryptamine stores caused by 4-methyl-alpha-metatyramine . Eur J Pharmacol 5:357-366, 1969.Crossref 7. Hamberger B, Tuck JR: Effect of tricyclic antidepressants on the uptake of noradrenaline and 5-hydroxytryptamine by rat brain slices incubated in buffer or human plasma . Eur J Clin Pharmacol 5:229-235, 1973.Crossref 8. Bertilsson L, Åsberg M, Thorén P: Differential effect of clomipramine and nortriptyline on cerebrospinal fluid metabolites of serotonin and noradrenaline in depression . Eur J Clin Pharmacol 7:365-368, 1974.Crossref 9. Åsberg M, Ringberger VA, Sjöqvist F, et al: Monoamine metabolites in the cerebrospinal fluid and serotonin-uptake inhibition during treatment with chlorimipramine . Clin Pharmacol Ther 21:201-207, 1977. 10. Carlsson A: Drugs which block the storage of 5-hydroxytryptamine and related amines , in Erspamer V (ed): Handbuch der Experimentellen Pharmakologie . New York, Springer Publishing Co Inc, 1965, vol 19, pp 529-592. 11. Yaryura-Tobias JA, Bhagavan HN: L-Tryptophan in obsessive-compulsive disorders . Am J Psychiatry 134:1298-1299, 1977. 12. Carlsson A, Corrodi H, Fuxe K, et al: Effects of some antidepressant drugs on the depletion of intraneuronal brain catecholamine stores caused by 4-alpha-dimethyl-meta-tyramine . Eur J Pharmacol 5:367-373, 1969.Crossref 13. Gittleson NL: The effect of obsessions on depressive psychosis . Br J Psychiatry 112:253-259, 1966.Crossref 14. Gittleson NL: The phenomenology of obsessions in depressive psychosis . Br J Psychiatry 112:261-264, 1966.Crossref 15. Gittleson NL: Depressive psychosis in the obsessional neurotic . Br J Psychiatry 122:883-887, 1966.Crossref 16. Kendell RE, Discipio WJ: Obsessional symptoms and obsessional personality traits in patients with depressive illness . Psychol Med 1:65-72, 1970.Crossref 17. Vanggaard T: Atypical endogenous depression . Acta Psychiatr Scand ( (suppl 267) ):5-56, 1976. 18. Spitzer RL, Endicott J, Robins E: Research diagnostic criteria: Rationale and reliability . Arch Gen Psychiatry 35:773-782, 1978.Crossref 19. Mellström B, Braithwaite R: Ion-pair liquid chromatography of amitriptyline and metabolites in plasma . J Chromatogr 157:379-385, 1978.Crossref 20. Mellström B, Tybring G: Ion-pair liquid chromatography of steady-state plasma levels of chlorimipramine and demethylchlorimipramine . J Chromatogr 143:597-605, 1977.Crossref 21. Marks IM: New approaches to the treatment of obsessive-compulsive disorder . J Nerv Ment Dis 150:420-426, 1973.Crossref 22. Åsberg M, Montgomery SA, Perris C, et al: A comprehensive psychopathological rating scale . Acta Psychiatr Scand ( (suppl 271) ):5-27, 1978. 23. Cooper J: The Leyton Obsessional Inventory . Psychol Med 1:48-64, 1970.Crossref 24. Rack PH: Clomipramine (Anafranil) in the treatment of obsessional states with special reference to the Leyton Obsessional Inventory . J Int Med Res 1:397-402, 1973. 25. Allen JJ, Rack PH: Changes in obsessive-compulsive patients as measured by Leyton Inventory before and after treatment with clomipramine . Scott Med J 20:41-44, 1975. 26. Montgomery SA, Åsberg M: A new depression scale designed to be sensitive to change . Br J Psychiatry 134:382-389, 1979.Crossref 27. Anderson NH: Scales and statistics: Parametric and nonparametric . Psychol Bull 58:305-316, 1961.Crossref 28. Boneau CA: A note on measurement scales and statistical tests . Am Psychol 16:160-261, 1961.Crossref 29. Ferguson GA: Statistical Analysis in Psychology and Education . New York, McGraw-Hill Book Co, 1971, p 271.

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Nov 1, 1980

References