Predictors of Clinical Response to Escitalopram in Obsessive-Compulsive Disorder.
- Author:
Je Yeon YUN
1
;
Min Soo BYUN
;
Geumsook SHIM
;
Hye Youn PARK
;
Joon Hwan JANG
;
Jae Yeon HWANG
;
Sung Nyun KIM
;
Jun Soo KWON
Author Information
1. Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea. kwonjs@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Obsessive-compulsive disorder;
Escitalopram;
Treatment response;
Aggressive obsessions
- MeSH:
Antipsychotic Agents;
Citalopram;
Constipation;
Diagnostic and Statistical Manual of Mental Disorders;
Humans;
Obsessive Behavior;
Obsessive-Compulsive Disorder;
Outcome Assessment (Health Care);
Prescriptions;
Retrospective Studies;
Serotonin
- From:Korean Journal of Psychopharmacology
2011;22(4):214-222
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: In this study, we aimed to investigate the predictors of clinical response to escitalopram (ESC) in obsessive-compulsive disorder (OCD) from the baseline clinical characteristics. In addition, we aimed to search the differences of prescription pattern between responders and non-responders to ESC. METHODS: Two hundred and twenty-three patients who met the DSM-IV criteria for OCD and visited at least once after the initiation of ESC prescription were included in this study. A primary outcome measure was the Clinical Global Impression-Improvement scale (CGI-I), which was scored at the time of retrospective chart review. Responders were defined as those with a CGI-I score of 1 or 2 at the final point of evaluation. Baseline clinical characteristics, prescription patterns, and adverse events were compared between responders and non-responders. We also examined the validity of the prediction model regarding treatment response to ESC. RESULTS: The OCD patients having aggressive obsessions and related compulsions showed significantly decreased response rate to ESC (odd ratio=0.285) in comparison with the OCD patients not having aggressive symptom dimension (p=0.002). The maximum dose of ESC prescription and rate of antipsychotics combination were higher in responders in comparison to the nonresponders. Among the adverse effects, sedation and constipation showed significantly different occurrence rate between responders versus non-responders. CONCLUSION: Aggressive obsessions and related compulsions seem to be associated with poor clinical response to ESC in OCD. Obsessive-compulsive symptom dimension should be considered when choosing a serotonin reuptake inhibitor for OCD.
