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July 1996

Venlafaxine in Obsessive-compulsive Disorder-Reply

Author Affiliations

Dean Foundation for Health Research and Education University of Wisconsin 8000 Excelsior Dr, Suite 302 Madison, WI 53717-1914

Arch Gen Psychiatry. 1996;53(7):654-655. doi:10.1001/archpsyc.1996.01830070104017

In Reply  Yaryura-Tobias and Neziroglu have thoughtfully presented their experience with a small, double-blind, placebo-controlled trial of venlafaxine as a treatment for OCD. They note trends toward efficacy and suggest that the failure to find statistically significant differences is related to the short duration of their trial (8 weeks) and low doses of venlafaxine hydrochloride (225 mg/d, maximum dose). They are correct that a longer duration of treatment would be needed to conclude that venlafaxine was ineffective as a treatment for OCD, as most potent serotonin-reuptake inhibitors studied to date have showed continued improvement beyond 8 weeks. Whether higher doses of venlafaxine are needed is less clear, and their assertion that mean daily doses of fluoxetine and sertraline were "at or near the manufacturers' recommended maximum for treating patients who have depression" is inaccurate. Both fluoxetine and sertraline were effective at low doses (20 and 50 mg/d, respectively) and exhibited a flat

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