Akademik Veri Yönetim Sistemi
ARCHIVES OF PSYCHIATRY AND PSYCHOTHERAPY, cilt.20, sa.3, ss.42-54, 2018 (ESCI, Scopus)
Obsessive-compulsive disorder (OCD) is a common mental health disorder that occurs at all ages, but more commonly in younger people. It affects 1-1.5% of the general population. Many pharmacological therapies have been reported to diminish OCD symptoms, as well as increase the patient's quality of life. So far, several meta-analyses have directly compared such treatment approaches in treatment-responsive and treatment-resistant OCD. This review evaluated all treatment options for OCD in both children and adolescents, and aimed to establish whether existing pharmacological therapies work similarly well, taking into account medical comorbidities such as substance use, anxiety, metabolic disorders, and finally, an overview of issues related to safety and monitoring. Our review included data from 16 meta-analyses and 8 practical guidelines focusing on OCD patients. In adults with OCD, we found that combined therapy shows favorable outcomes versus SRI alone and produced better results. In children with OCD the greatest incremental treatment gains occur early in treatment with selective serotonin reuptake inhibitors (SSRIs). Finally, in treatment-resistant OCD augmentation of SRIs can be regarded as an evidence-based measure in pharmacological therapy. The results of this review mostly support the previous reviews on the pharmacological management of OCD. However, we noted that combination/augmentation of SSRIs significantly improved symptoms in treatment-resistant OCD compared with monotherapy. From a clinical perspective, antipsychotics combination/augmentation of SSRIs should be used in comorbid psychosis, a frequent comorbidity in OCD, especially as the presence of comorbidities is highly associated with treatment resistance in OCD.