Venlafaxine in treatment-resistant obsessive-compulsive disorder

Eric Hollander, Jennifer Friedberg, Stacey Wasserman, Andrea Allen, Melissa Birnbaum, Lorrin M. Koran

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


Background: While selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment of obsessive-compulsive disorder (OCD), approximately 40% of patients fail to respond to SSRIs. Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that might be effective in the treatment of OCD, even among those who have failed previous SSRI trials. Method: Thirty-nine patients who met DSM-IV criteria for OCD, including 29 who were resistant to prior SRI treatment trials, were treated with venlafaxine in an open, naturalistic fashion. Improvement was assessed using the Clinical Global Impressions-Improvement scale. Results: Of 39 patients treated with venlafaxine, 27 (69.2%) were rated as sustained treatment responders. Of the 29 patients who did not respond to 1 or more previous SRI trials, 22 (75.9%) were rated as having sustained response to treatment. Mean dose of venlafaxine was 232.2 mg/day (range, 37.5-375 mg/day), and it was generally well tolerated. Conclusion: Venlafaxine may be beneficial to individuals with OCD, including those who have not responded to prior SSRI trials. However, these findings must be interpreted with caution, as the study is limited by its open, retrospective nature and its inclusion of patients with comorbid diagnoses and patients on concomitant medications. Prospective, controlled trials with a more homogeneous patient population are needed to replicate these preliminary findings.

Original languageEnglish (US)
Pages (from-to)546-550
Number of pages5
JournalJournal of Clinical Psychiatry
Issue number5
StatePublished - May 1 2003
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health


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