Treatment of obsessive-compulsive disorder with serotonergic agents

Recent pharmacologic advances have significantly improved the treatment and prognosis of obsessive-compulsive disorder (OCD). Clomipramine has been the drug most studied and has been proved uniformly beneficial. More recently, controlled trials of the serotonin-selective uptake inhibitors fluoxetine and fluvoxamine have shown similar efficacy in OCD. The novel anxiolytic drug buspirone has been used as a primary agent as well as an augmenting agent in the treatment of OCD. The efficacy of buspirone in these initial studies requires further validation but supports the hypothesis that drugs that are therapeutically effective in OCD may share common serotonin-mediated mechanisms of action.