The recent study of Denys et al. (
1) prompts us to draw attention to several non-serotonergic effects of selective serotonin reuptake inhibitors (SSRIs), including dopaminergic effects. Denys et al. reported two major findings from a post hoc analysis of three quetiapine augmentation studies in 102 obsessive-compulsive disorder (OCD) patients treated with SRIs. Firstly, therapeutic benefit from augmentation depended on the particular SRI used, with response observed only in patients taking fluoxetine, fluvoxamine, and clomipramine. Secondly, lower dosage of SRIs was associated with greater benefit from augmentation in this study. The observations are novel, interesting, and deserve further discussion. Starting with limitations of the prevailing serotonergic perspective on OCD, we will add some interrelated considerations regarding firstly dopaminergic effects of SSRIs, secondly pharmacokinetics of SSRI, and thirdly influences of symptom profile on outcome.
- Denys D.
- Fineberg N.
- Carey P.D.
- Stein D.J.
Quetiapine addition in obsessive-compulsive disorder: Is treatment outcome affected by type and dose of serotonin reuptake inhibitors?.
Biol Psychiatry. 2007; 61: 412-414
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- Quetiapine addition in obsessive-compulsive disorder: Is treatment outcome affected by type and dose of serotonin reuptake inhibitors?.Biol Psychiatry. 2007; 61: 412-414
- “Dopamine-dependent” side effects of selective serotonin reuptake inhibitors: A clinical review.J Clin Psychiatry. 2004; 65: 1064-1068
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Published online: August 15, 2007
© 2008 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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- Quetiapine Addition in Obsessive-Compulsive Disorder: Is Treatment Outcome Affected by Type and Dose of Serotonin Reuptake Inhibitors?Biological PsychiatryVol. 61Issue 3
- ReplyBiological PsychiatryVol. 63Issue 1
- PreviewWe are grateful to Dr. Zurowski et al. for their interest in our article. They noted problems in the serotonin hypothesis and advantages in the dopamine hypothesis of obsessive–compulsive disorder (OCD), pointed out dopaminergic effects of selective serotonin reuptake inhibitors (SSRIs), and suggested that pharmacokinetics and symptom profiles accounted for our findings.