First, although the maximum recommended dose of fluoxetine, 80 mg/day, was administered, the maximum recommended dose of phenelzine, 90 mg/day, was not. Instead, only a dose of 60 mg/day was given. This was probably based on the ease of administering one to four 20-mg doses of fluoxetine and one to four 15-mg doses of phenelzine. In any event, comparing the maximum dose of one drug to a lesser dose of another drug would invalidate any conclusions regarding comparative efficacy. The authors’ statement, "Phenelzine was no better than placebo" would be more accurate if it began with the phrase, "Low-dose phenelzine." In our experience and in the literature (R15601CHDDHHEI), when phenelzine is used for OCD, doses as high as 105 mg/day may be needed. In addition, measuring the monoamine oxidase (MAO) inhibition level is questionable here because, unlike depression, the level of MAO inhibition required for OCD responsiveness has not been established.