Paroxetine versus clomipramine in the treatment of obsessive-compulsive disorder

Background. The aim was to assess the effect of a flexible dose of paroxetine, compared with clomipramine and placebo in obsessive-compulsive disorder (OCD). Method. In a multinational randomised study, 406 subjects with OCD of at least. six months duration received double-blind medication for up to 12 weeks. Doses were adjusted according to therapeutic effect and side-effects. Primary efficacy measures were the Yale-Brown Obsessive-Compulsive Scale and the National Institute of Mental Health Obsessive-Compulsive Scale. Secondary efficacy measures were the Montgomery-Asberg Depression Rating Scale, Symptom Check-List (90), Clinical Global impression, and Patients' Global Evaluation. Results. Paroxetine was significantly more effective than placebo and of comparable efficacy to clomipramine. Paroxetine had significantly superior tolerability to clomipramine on three measures: CGI efficacy index, anticholinergic adverse events, and adverse events leading to withdrawal. Conclusion. Paroxetine is as effective as clomipramine in the treatment of OCD. The comparable efficacy and better tolerability of paroxetine suggest that it would be an appropriate treatment for OCD.