Double-blind comparison of fluoxetine versus clomipramine in the treatment of obsessive compulsive disorder.

There is evidence of the clinical efficacy and safety of clomipramine and the newer selective serotonin reuptake inhibitors (SSRIs) for the treatment of obsessive-compulsive disorder (OCD). In the present study, we have compared the efficacy and safety of 40 mg/day of fluoxetine and 150 mg/day of clomipramine in patients with OCD, diagnosed according to DSM-IIIR. A total of 55 patients entered this 8-week, double-blind controlled study. Efficacy for both drugs was comparable. The primary efficacy criterion, the Y-BOCS Total score, did not show any significant differences between treatment arms. Response rate was higher with clomipramine, using a 25% decrease in Y-BOCS Total score as response threshold, but there were no significant differences between treatment arms using a 35% threshold. Overall safety and tolerability were good for both drugs, being slightly better for fluoxetine.

[Dysmorphophobia: past and present of a centuries-old disorders]. / Dismorfofobia: pasado y presente de un trastorno centenario.

Dysmorphophobia is a very interesting psychiatric syndrome that remains controversial, despite it being described more than a century ago. Current knowledge allow us to think of it as a clinical entity in itself, but its relationship with affective disorders and obsessive-compulsive disorder remain unclear. Delusional and non-delusional dysmorphophobia might be two separate disorders or, more likely, variants of the same disorder. Several therapeutic approaches have shown efficacy in the treatment of this condition, like pimozide, serotonergic antidepressants and cognitive-behaviour therapy, but well controlled clinical trials are lacking. It has still to be determined to what extent all this findings about dysmorphophobia in clinical samples do apply to people with body image disorders in the general population.