Treatments used for obsessive–compulsive disorder—An international perspective

Vlasios Brakoulias, Vladan Starcevic, Umberto Albert, Shyam Sundar Arumugham, Brenda E. Bailey, Amparo Belloch, Tania Borda, Liliana Dell'Osso, Jason A. Elias, Martha J. Falkenstein, Ygor A. Ferrao, Leonardo F. Fontenelle, Lena Jelinek, Leto Kalogeraki, Brian Kay, Luana D. Laurito, Christine Lochner, Giuseppe Maina, Donatella Marazziti, Andrew MartinHisato Matsunaga, Euripedes C. Miguel, Pedro Morgado, Irakis Mourikis, Massimo Pasquini, Rodrigo Perez Rivera, Sriramya Potluri, Janardhan Y.C. Reddy, Brian C. Riemann, Maria Conceição do Rosario, Roseli G. Shavitt, Dan J. Stein, Kirupumani Viswasam, Zhen Wang, Naomi A. Fineberg

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Objective: The objective of this study was to characterise international trends in the use of psychotropic medication, psychological therapies, and novel therapies used to treat obsessive–compulsive disorder (OCD). Methods: Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their samples. Consistency of summary statistics across countries was evaluated. Results: The study surveyed 19 expert centres from 15 countries (Argentina, Australia, Brazil, China, Germany, Greece, India, Italy, Japan, Mexico, Portugal, South Africa, Spain, the United Kingdom, and the United States) providing a total sample of 7,340 participants. Fluoxetine (n = 972; 13.2%) and fluvoxamine (n = 913; 12.4%) were the most commonly used selective serotonin reuptake inhibitor medications. Risperidone (n = 428; 7.3%) and aripiprazole (n = 415; 7.1%) were the most commonly used antipsychotic agents. Neurostimulation techniques such as transcranial magnetic stimulation, deep brain stimulation, gamma knife surgery, and psychosurgery were used in less than 1% of the sample. There was significant variation in the use and accessibility of exposure and response prevention for OCD. Conclusions: The variation between countries in treatments used for OCD needs further evaluation. Exposure and response prevention is not used as frequently as guidelines suggest and appears difficult to access in most countries. Updated treatment guidelines are recommended.

Original languageEnglish
Article numbere2686
Number of pages10
JournalHuman Psychopharmacology
Issue number1
Publication statusPublished - 1 Jan 2019


  • antipsychotics
  • benzodiazepines
  • cross-cultural study
  • obsessive–compulsive disorder
  • pharmacotherapy
  • selective serotonin reuptake inhibitors

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