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QUESTION: Which characteristics of published trials might account for differences in the effect of clomipramine and selective serotonin reuptake inhibitors in obsessive-compulsive disorder?
Studies were identified using Medline, Current Contents, PsychInfo, published reviews and previous meta-analyses.
Studies were eligible if they were randomised, double-blind parallel trials of at least 8 weeks duration; used the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to assess the efficacy of clomipramine or selective serotonin reuptake inhibitors for obsessive-compulsive disorder, and included point estimates, standard deviations or calculable data. The authors included 25 trials.
Data were extracted on effect size, drug interactions, participant characteristics, inclusion and exclusion criteria, length of trial, trial size and publication year. Meta-regression was used to identify sources of heterogeneity.
Factors associated with improved response to clomipramine were younger age, early onset obsessive-compulsive disorder, …
Review: in obsessive-compulsive disorder, clomipramine may be more effective than selective serotonin reuptake inhibitors after controlling for
Eric Hollander and Jessica Kahn (commentator)
Ackerman D, Greenland S. Multivariate meta-analysis of controlled drug studies for obsessive-compulsive disorder. Journal of Clinical Psychopharmacology 2002 June; 22: 309�17.
Web-only Additional Commentary
Maria C Rosario-Campos MD, MSc, Child Study Center, Yale University School of Medicine, New Haven, USA
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