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January 1984

Behavior Therapy-Reply

Author Affiliations

Department of Psychiatry Behavior Therapy Section Eastern Pennsylvania Psychiatric Institute Henry Avenue Philadelphia, PA 19129

Arch Gen Psychiatry. 1984;41(1):107-108. doi:10.1001/archpsyc.1984.01790120111019

In Reply.—  We do not feel that Dr Feldman's letter raises any substantial issues with respect to the treatment of obsessive-compulsives. Studies by Rachman et al suggest that reduction of anxiety by relaxation does not potentiate the effectiveness of exposure with obsessive-compulsives.1 Of course, refusals are a cause for concern and it may be that they are higher for treatments that include deliberate exposure and response prevention. However, those who elected to participate in our programs did not drop out prematurely, in contrast to drug treatment programs in which noncompliance and premature termination are a major problem.A variety of drugs have been tried with obsessive-compulsives. Most of the information available on their efficacy is derived from case reports and uncontrolled studies, which are at best suggestive.2 Few controlled studies investigated the effect of antidepressants, especially clomipramine, in this population.3-5 The results to date seem to indicate that clomipramine potentiates

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