Post-treatment effects of exposure therapy and clomipramine in obsessive-compulsive disorder

H. Blair Simpson*, Michael R. Liebowitz, Edna B. Foa, Michael J. Kozak, Andrew B. Schmidt, Vivienne Rowan, Eva Petkova, Kevin Kjernisted, Jonathan D. Huppert, Martin E. Franklin, Sharon O. Davies, Raphael Campeas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

115 Scopus citations

Abstract

We sought to determine whether adults with obsessive-compulsive disorder (OCD) who respond to intensive exposure and response (ritual) prevention (EX/RP) with or without clomipramine (CMI) fare better 12 weeks after treatment discontinuation than responders receiving CMI alone. After receiving 12 weeks of treatment (EX/RP, CMI, EX/RP+CMI, or pill placebo [PBO] in a randomized clinical trial conducted at three outpatient research centers), 46 adults with OCD who responded to treatment (18 EX/RP, 11 CMI, 15 EX/RP+CMI, 2 PBO) were followed after treatment discontinuation for 12 weeks. Patients were assessed every 4 weeks with the Yale-Brown Obsessive-Compulsive Scale, the National Institutes of Health Global Obsessive-Compulsive Scale, and the Clinical Global Impressions scale by an evaluator who was blind to original treatment assignment. The primary hypothesis was that EX/RP and EX/RP+CMI responders would be less likely to relapse 12 weeks after treatment discontinuation than responders to CMI alone. Twelve weeks after treatment discontinuation, EX/RP and EX/RP+CMI responders, compared to CMI responders, had a significantly lower relapse rate (4/33 = 12% versus 5/11 = 45%) and a significantly longer time to relapse. The CMI relapse rate was lower than previously reported. Nonetheless, responders receiving intensive EX/RP with or without CMI fared significantly better 12 weeks after treatment discontinuation than responders receiving CMI alone.

Original languageAmerican English
Pages (from-to)225-233
Number of pages9
JournalDepression and Anxiety
Volume19
Issue number4
DOIs
StatePublished - 2004
Externally publishedYes

Keywords

  • Anxiety disorders
  • CMI
  • Cognitive behavioral therapy
  • Discontinuation
  • EX/RP
  • OCD
  • Randomized controlled trial
  • Relapse

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