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High-dose sertraline strategy for nonresponders to acute treatment for obsessive-compulsive disorder: a multicenter double-blind trial.

Publication ,  Journal Article
Ninan, PT; Koran, LM; Kiev, A; Davidson, JRT; Rasmussen, SA; Zajecka, JM; Robinson, DG; Crits-Christoph, P; Mandel, FS; Austin, C
Published in: J Clin Psychiatry
January 2006

OBJECTIVE: To evaluate the efficacy and safety of high-dose sertraline for patients with obsessive-compulsive disorder (OCD) who failed to respond to standard sertraline acute treatment. METHOD: Sixty-six nonresponders to 16 weeks of sertraline treatment who met DSM-III-R criteria for current OCD were randomly assigned, in a double-blind continuation phase of a multicenter trial, either to continue on 200 mg/day of sertraline or to increase their dose to between 250 and 400 mg/day for 12 additional weeks. Efficacy measures included the Yale-Brown Obsessive Compulsive Scale (YBOCS), the National Institute of Mental Health Global Obsessive Compulsive Scale (NIMH Global OC Scale), and the Clinical Global Impressions-Severity of Illness and -Improvement (CGI-I) scales. Data were collected from July 26, 1994, to October 26, 1995. RESULTS: The high-dose (250-400 mg/day, mean final dose = 357, SD = 60, N = 30) group showed significantly greater symptom improvement than the 200-mg/day group (N = 36) as measured by the YBOCS (p = .033), NIMH Global OC Scale (p = .003), and CGI-I (p = .011). Responder rates (decrease in YBOCS score of > or = 25% and a CGI-I rating < or = 3) were not significantly different for the 200-mg/day versus the high-dose sertraline group, either on completer analysis, 34% versus 52%, or on endpoint analysis, 33% versus 40%. Both treatments showed similar adverse event rates. CONCLUSION: Greater symptom improvement was seen in the high-dose sertraline group compared to the 200-mg/day dose group during continuation treatment. Both dosages yielded similar safety profiles. Administration of higher than labeled doses of selective serotonin reuptake inhibitors may be a treatment option for certain OCD patients who fail to respond to standard acute treatment.

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Published In

J Clin Psychiatry

DOI

ISSN

0160-6689

Publication Date

January 2006

Volume

67

Issue

1

Start / End Page

15 / 22

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Sertraline
  • Selective Serotonin Reuptake Inhibitors
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Placebos
  • Obsessive-Compulsive Disorder
  • Male
  • Humans
 

Citation

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Ninan, P. T., Koran, L. M., Kiev, A., Davidson, J. R. T., Rasmussen, S. A., Zajecka, J. M., … Austin, C. (2006). High-dose sertraline strategy for nonresponders to acute treatment for obsessive-compulsive disorder: a multicenter double-blind trial. J Clin Psychiatry, 67(1), 15–22. https://doi.org/10.4088/jcp.v67n0103
Ninan, Philip T., Lorrin M. Koran, Ari Kiev, Jonathan R. T. Davidson, Steven A. Rasmussen, John M. Zajecka, Delbert G. Robinson, Paul Crits-Christoph, Francine S. Mandel, and Carol Austin. “High-dose sertraline strategy for nonresponders to acute treatment for obsessive-compulsive disorder: a multicenter double-blind trial.J Clin Psychiatry 67, no. 1 (January 2006): 15–22. https://doi.org/10.4088/jcp.v67n0103.
Ninan PT, Koran LM, Kiev A, Davidson JRT, Rasmussen SA, Zajecka JM, et al. High-dose sertraline strategy for nonresponders to acute treatment for obsessive-compulsive disorder: a multicenter double-blind trial. J Clin Psychiatry. 2006 Jan;67(1):15–22.
Ninan, Philip T., et al. “High-dose sertraline strategy for nonresponders to acute treatment for obsessive-compulsive disorder: a multicenter double-blind trial.J Clin Psychiatry, vol. 67, no. 1, Jan. 2006, pp. 15–22. Pubmed, doi:10.4088/jcp.v67n0103.
Ninan PT, Koran LM, Kiev A, Davidson JRT, Rasmussen SA, Zajecka JM, Robinson DG, Crits-Christoph P, Mandel FS, Austin C. High-dose sertraline strategy for nonresponders to acute treatment for obsessive-compulsive disorder: a multicenter double-blind trial. J Clin Psychiatry. 2006 Jan;67(1):15–22.

Published In

J Clin Psychiatry

DOI

ISSN

0160-6689

Publication Date

January 2006

Volume

67

Issue

1

Start / End Page

15 / 22

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Sertraline
  • Selective Serotonin Reuptake Inhibitors
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Placebos
  • Obsessive-Compulsive Disorder
  • Male
  • Humans