OBJECTIVE: The purpose of this study was to determine whether combined
treatment with a selective serotonin reuptake inhibitor (SSRI) and a
norepinephrine reuptake inhibitor, desipramine, effectively reduces
obsessive-compulsive symptoms in patients who do not respond to SSRIs.
METHOD: In a double-blind study, desipramine or placebo was added for 6 or
10 weeks to the treatment of 30 patients with obsessive-compulsive disorder
whose symptoms were refractory to SSRI treatment (fluvoxamine, fluoxetine,
or sertraline) alone. RESULTS: There were no significant differences
between the adjunctive desipramine and placebo groups in
obsessive-compulsive or depressive symptoms. CONCLUSIONS: These data
suggest that clomipramine's possibly superior efficacy in the treatment of
obsessive-compulsive symptoms may not stem from its capacity to inhibit
reuptake of norepinephrine.