Selective serotonin re-uptake inhibitors are effective for obsessive compulsive disorder

Clinical question: 
How effective are selective serotonin re-uptake inhibitors (SSRIs) for obsessive compulsive disorder (OCD) in adults?
Bottom line: 
Compared to placebo, SSRIs are more effective for OCD in adults, at least in the short term (up to 3 months). People receiving SSRIs are nearly twice as likely as those receiving placebo to achieve clinical response (defined as 25% or greater reduction in symptoms). In a group of patients where 10% might be expected to recover even without treatment, the NNT*=12, whereas in a group where 20% might be expected to recover even without treatment, the NNT=6. SSRIs included in the studies included citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline. *NNT = number needed to treat to benefit 1 individual.
Caveat: 
Indirect comparisons of effectiveness suggested, although individual SSRIs were similar in their effectiveness, they differed in terms of their adverse effects, the commonest one overall being nausea.
Context: 
OCD is a common and disabling disorder, which frequently follows a chronic course. It has a lifetime prevalence of 2.2% in New Zealand.ยน 1. Bebbington PE. Br J Psychiatry 1998;35:2-6.
Review CD#: 
CD001765
PEARLS No: 
129
Date: 
June, 2008
Authored by: 
Brian R McAvoy