A Cochrane review [Abstract] 1 included 17 studies with a total of 3 097 subjects. Five studies compared sertraline against placebo, five fluvoxamine, three fluoxetine, three studies paroxetine and one study citalopram. Age of participants in general was 17 years or above and all studies included both men and women. All studies used similar diagnostic criteria for OCD i.e. DSM III or a later version of this system. All studies included either less than severe or severe secondary depression as a co-morbid disorder.
Based on all 17 studies, SSRIs as a group were more effective than placebo in reducing the symptoms of OCD between 6 and 13 weeks post-treatment, measured using the Yale-Brown Obsessive Compulsive Scale (YBOCS) (WMD -3.21, 95% CI -3.84 to -2.57). The WMD for individual SSRI drugs were similar and not statistically different. Based on 13 studies (2 697 participants), SSRIs were more effective than placebo in achieving clinical response at post-treatment (RR 1.84, 95% CI 1.56 to 2.17). The pooled RR was shown to be similar between individual SSRI drugs. The overall and individual adverse effects like nausea, headache and insomnia for the different SSRIs were worse than for placebo and statistically significant.
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