Lexapro for the Treatment of OCD?

Lexapro doses for OCD may differ from doses used to treat depression

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Obsessive compulsive disorder (OCD) is characterized by obsessive thoughts and behaviors.  Patients may be prescribed escitalopram (often sold as Lexapro), an antidepressant, to help with some symptoms.

Escitalopram is approved to treat depression and anxiety, and it is sometimes used to treat obsessive compulsive disorder (OCD), which is an anxiety disorder.

A recent study suggests that very high doses have more side effects without offering any benefits compared to lower doses.

"Ask your psychiatrist about OCD treatment options."

Researchers, led by Geumsook Shim with Jun Soo Kwon, MD, of the Department of Psychiatry, Seoul National University, in Seoul, Korea, looked at how well escitalopram worked for patients with OCD.

They looked at the records of 246 patients with OCD and classified people who took escitalopram as having a very high dose, a high dose, or a standard dose.  A very high dose was greater than 40 mg/day and a standard dose was less than 20 mg/day.

The recommended doses for the treatment of depression and anxiety with escitalopram range from 10 to 20 mg/day.

Then they looked at the global function scores of the patients before and after taking escitalopram. Global function scores are given by clinicians. They are rated based upon overall improvement of symptoms and life functioning.

Of the patients taking very high doses, 46.3 percent of them showed improvement. When patients took high doses, between 20 and 40 mg/day, 43.2 percent of them showed improvement.

The standard dose group had 26.2 percent of the people showing improvement.

They also found that the higher the doses, the more side effects people reported.

The authors concluded that escitalopram is effective for treating OCD but that very high doses are not necessary. The doses between 20 and 40 mg/day were just as effective as the higher doses but without as many side effects.

However, this study was retrospective – meaning they looked back at patient records and global functioning scores after the fact.  They did not track patients or get any real-time information about medication response or side effects.

More research is needed using controlled trials to understand the optimum dose of escitalopram for the treatment of obsessive compulsive disorder.

The study report was published in the September issue of the International Clinical Psychopharmacology. The authors report no conflicts of interest.

Reviewed by: 
Review Date: 
July 5, 2012
Last Updated:
December 20, 2012