OCD 20 Years Ago & Today

Obsessive compulsive disorders that responded to meds better able to manage symptoms later

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Back in the late 1980s, medications designed to manage OCD symptoms were tested in clinical trials. Now, participants from one of those trials have reported on life 20 years later.

A group of mental health professionals at Yale contacted participants from a clinical trial of obsessive-compulsive disorder (OCD) medications 15 to 20 years ago to follow-up.

The results of the study showed that most of the people who responded to one of the medications in the original trial had fewer symptoms later in life.

Patients that did not respond to one of the medications in the initial trial were more likely to still have OCD symptoms 15 to 20 years later.

"See a therapist for obsessive-compulsive symptoms."

Michael H. Bloch, MD, assistant professor in the Child Study Center and chief resident at the Clinical Neuroscience Research Unit in the Department of Psychiatry at Yale University in New Haven, CT, led a team to research what happens to people with OCD in the long-term.

OCD is characterized by unreasonable thoughts and fears that lead a person to perform repetitive behaviors, according to the Mayo Clinic.

For this study, the researchers contacted 165 people that had been treated with medications for OCD between 1986 and 1995 at the Yale OCD Research Clinic.

Each of the trial participants had been prescribed one of three serotonin reuptake inhibitors (SRIs) for at least eight weeks. The three SRI medications included in the trials were two SSRI antidepressants, fluoxetine (Prozac) and fluvoxamine (Luvox), and a tricyclic antidepressant, clomipramine (Anafranil).

SRI medications are not often prescribed today. The more modern class of medication – selective serotonin reuptake inhibitors (SSRIs) – have become more common. 

Having had no contact with the Yale OCD Research Clinic for 10 to 20 years, 83 of the original trial participants agreed to be part of this follow-up study. Participants were interviewed about their current OCD symptoms.

The results of the study showed that 20 percent of the group no longer experienced symptoms of OCD. Overall, 71 percent of the 83 participants were still taking medication to manage their OCD.

Nearly half (49 percent) of the group still had enough symptoms of OCD to meet the criteria for clinical diagnosis of OCD.

The researchers found that people who experienced benefits from antidepressants were less likely to have OCD symptoms later in life.

There were 16 people who had no response to the medications they were given in the original trial. All of those 16 people still had symptoms of OCD. The authors said that 12 of the 16 had severe enough symptoms to qualify for another OCD treatment study.

Only 31 percent of people who initially responded to the medications in the trial no longer had OCD symptoms that met the criteria for clinical diagnosis of OCD. While 51 percent of the group had gone through cognitive behavioral therapy at some point, only 8 percent were still doing it at the time of the study.

Cognitive behavioral therapy for OCD involves a mental health professional exposing patients to things that would typically trigger an obsessive thought and then training them to prevent the compulsive action.

The authors concluded that initial response to medication was linked to better long-term management of OCD symptoms.

The authors expressed that there continues to be a real need for development of treatments for OCD.

This was published in March in Depression and Anxiety.

The National Institute of Mental Health, Eli Lilly Psychiatric Research Fellowship, the Trichotillomania Learning Center, the National Institutes of Health and various charitable organizations supported the funding of this project. Several of the doctors involved with this study disclosed financial relationships with pharmaceutical companies.

Reviewed by: 
Review Date: 
March 25, 2013
Last Updated:
December 31, 2013