Intravenous Clomipramine for Treatment-Resistant Obsessive-Compulsive Disorder

Int J Neuropsychopharmacol. 2015 Jul 28;19(2):pyv084. doi: 10.1093/ijnp/pyv084.

Abstract

Background: This open trial was conducted to evaluate the effectiveness of intravenous clomipramine (CMI) in refractory obsessive-compulsive disorder (OCD).

Methods: Thirty OCD poor responders to previous multiple trials of anti-obsessive medications were selected and admitted to the hospital. Severity of the illness and response to treatment were primarily assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). CMI was gradually administered intravenously for one week. All patients were thereafter switched to oral CMI with a maximum dose of 225 mg/day.

Results: The Y-BOCS total score mean at admission was in the severe range (24-31), and dropped on discharge and follow-ups to the moderate range (16-23). At discharge, 23 patients (76.7%) had a decrease in Y-BOCS ≥ 25% and were considered responders, while only 18 (60%) were still responders at 24 weeks. No relevant persistent side effects were reported.

Conclusion: Intravenous clomipramine could be of benefit for severe OCD cases that have not adequately responded to several therapies, including oral clomipramine.

Keywords: clomipramine; intravenous clomipramine; obsessive-compulsive disorder; treatment-resistant OCD.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Intravenous
  • Adolescent
  • Adult
  • Clomipramine / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Obsessive-Compulsive Disorder / diagnosis*
  • Obsessive-Compulsive Disorder / drug therapy*
  • Obsessive-Compulsive Disorder / psychology
  • Selective Serotonin Reuptake Inhibitors / administration & dosage*
  • Treatment Outcome
  • Young Adult

Substances

  • Serotonin Uptake Inhibitors
  • Clomipramine