COMPARING THE EFFECT OF SECOND-GENERATION ANTIPSYCHOTICS VERSUS SELECTIVE SEROTONIN REUPTAKE INHIBITORS IN REFRACTORY OBSESSIVE-COMPULSIVE DISORDER: A SYSTEMATIC REVIEW OF THE PAST, PRESENT, AND FUTURE CLINICAL TRIALS

摘要

Objective: In this concise and systematic review, the trend of using major medication modalities prescribed for refractory obsessive-compulsive disorder (OCD), including serotonin-specific reuptake inhibitors (SSRIs) and second-generation antipsychotics (SGAs) are discussed. Methods: We systematically searched PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) systematically using Mesh terms. OCD is extremely disabling and associated with considerable depression and other serious psychiatric illnesses. Results: Through databases, we found 78 randomized clinical trials (RCTs), which included selective SSRI compared with routine drug therapy or placebo. Out of these 78 studies, 62 studies were conducted on adult patients with OCD, comprising 7920 cases. While only 16 RCTs were performed on children and adolescents with OCD, including 1313 people. We found 24 clinical trial studies related to SGAs, of which were conducted on adult patients with OCD, including 992 cases. Conclusion: As our data showed among the SSRIs, fluvoxamine has been particularly well studied and used in RCTs in both children and adolescents with OCD. According to the summary of our review, it will be better when therapists use SGAs in the early treatment programs of refractory OCD. Thus, considering our reviewed, it seems that the first choice of early treatment programs of refractory OCD is fluvoxamine in combination with quetiapine or aripiprazole. Keywords: Obsessive-compulsive disorder, Refractory, Second-generation antipsychotic drugs, Selective serotonin reuptake inhibitors.