Unlike depression, which responds to a variety of antidepressant agents, OCD appears to require treatment with a serotonergic agent. Clomipramine, the most serotonergic of the tricyclics, is approved by the FDA for use in OCD, and its efficacy in this disorder is well established (Greist et al. 1995). Studies comparing its effectiveness with noradrenergic agents such as desipramine found that clomipramine was substantially superior (Leonard et al. 1989). Although the SSRIs are effective in treating OCD, there is a suggestion that clomipramine may be superior (Greist et al. 1995). Whether this putative superiority is due to the dual mechanism of clomipramine or to other factors is unclear.
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