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Table 26 Strength of evidence of pharmacotherapy for OCD

From: Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

Agent

Level of evidence

Agent

Level of evidence

Antidepressants

SSRIs

 

MAOIs

 

Escitalopram [705–709]

1

Phenelzine [737, 738]

2*

Fluoxetine [660, 710–716]

1

Tranylcypromine [739]

4

Fluvoxamine [711, 713, 714, 717–719]

1

TCAs

 

Paroxetine [705, 720–722]

1

Clomipramine [658, 711, 713, 714, 716–718, 720, 724, 740, 741]

1

Sertraline [659, 710, 711, 713, 714, 723–725]

1

IV clomipramine [742–744]

2

Citalopram [680, 726–728]

2

Desipramine [723, 745]

2 (-ve)

IV citalopram [729]

3

Adjunctive clomipramine [746, 747]

2 (-ve)

Adjunctive citalopram [730]

3

Other antidepressants

 

SNRIs

 

Mirtazapine [748]

2

Venlafaxine XR [721, 731–733]

2

Bupropion [749]

3 (-ve)

Duloxetine [734–736]

4

Adjunctive mirtazapine [727]

3

Other therapies

Antipsychotics

 

Anxiolytics

 

Adjunctive aripiprazole [750–755]

1

    Benzodiazepines

 

Adjunctive risperidone [755–761]

1*

      Clonazepam [771]

2 (-ve)

Adjunctive olanzapine [760, 762, 763]

1*

      Adjunctive clonazepam [772]

2 (-ve)

Adjunctive quetiapine [728, 746, 747, 764–768]

1*

Other treatments

 

Adjunctive haloperidol [758, 769]

2

Clonidine [773]

2 (-ve)

Adjunctive amisulpride [770]

3

Adjunctive pindolol [774–776]

1*

Adjunctive ziprasidone [767]

4

Adjunctive celecoxib [777]

2

Anticonvulsants

 

Adjunctive granisetron [778]

2

Adjunctive topiramate [795–798]

1*

Adjunctive IV ketamine [779, 780]

2

Adjunctive lamotrigine [799, 800]

2

Adjunctive memantine [622, 781–783]

2

Adjunctive pregabalin [801, 802]

3

Adjunctive ondansetron [784, 785]

2

Adjunctive gabapentin [803, 804]

3 (-ve)

Adjunctive N-acetylcysteine [786, 787]

2

Opioids

 

Adjunctive riluzole [788, 789]

3

Tramadol [805, 806]

4

Adjunctive lithium [790, 791]

1 (-ve)

Naltrexone [807]

3 (-ve)

Adjunctive buspirone [792, 793]

2 (-ve)

Adjunctive morphine [808]

2

Adjunctive minocycline [794]

4 (-ve)

  1. *Conflicting data. IV = intravenous; MAOI = monoamine oxidase inhibitor; SNRI = serotonin–norepinephrine reuptake inhibitor; SSRI = selective serotonin reuptake inhibitor; TCA = tricyclic antidepressant; XR = extended release; (-ve) = negative.
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BMC Psychiatry

ISSN: 1471-244X

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