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Venlafaxine Equals Paroxetine for Obsessive-Compulsive Disorder: Presented at APA

By Bruce Sylvester

PHILADELPHIA, PA -- May 21, 2002 -- Effexor (venlafaxine) appears to be equally effective to Paxil (paroxetine) for the treatment of obsessive-compulsive disorder (OCD), researchers report.

The results from the first randomized, double-blind, head-to-head study comparing the two drugs for the treatment of OCD were presented here on May 20 at the annual meeting of the American Psychiatric Association (APA).

"We wanted to find out how a compound acting on two different brain systems -- serotonin and norepinephrine -- compared in OCD treatment to a compound acting only on serotonin" said lead researcher Harold Van Megen, MD, associate professor of medicine, University of Utrecht, Netherlands. "We found the efficacy of each drug to be comparable."

Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) and paroxetine is a selective serotonin reuptake inhibitor (SSRI).

The researchers recruited 150 subjects with primary OCD, according to Diagnostic and Statistical Manual IV (DSM-IV) criteria. In the 12-week trial, they randomly assigned 74 subjects to receive dosages titrated upward to 300 mg/day of venlafaxine and 76 to receive 60 mg/day of paroxetine.

Efficacy of treatment was assessed according to changes from baseline on the Yale-Brown obsessive-compulsive scale (Y-BOCS). They defined a clinical response as a decrease of 25 percent on the Y-BOCS. They also made assessments with the Hamilton depression rating scale and Hamilton anxiety rating scale.

The researchers found a 60 percent positive response in both groups of subjects. There was a mean decrease on the Y-BOCS of 30±29.5 percent in the venlafaxine group and of 30±26 percent in the paroxetine group.

"The take-home message here is about an alternative for patients experiencing difficult side effects on paroxetine," Dr. Van Megan said. "If an OCD patient has side effect problems with paroxetine, we can now say that a switch to venlafaxine could be equally efficacious for OCD treatment."

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