강박장애의 약물치료 전략

Abstract

Obsessive-compulsive disorder (OCD) has a lifetime prevalence of approximately 2-3%. Until relatively recently, effective treatments for OCD were lacking. Fortunately, over the past decades, the availability of serotonin reuptake inhibitors (SRIs) and behavioral treatments using exposure-response prevention techniques has altered the outlook for patients suffering from OCD. But, treating OCD with medication still requires a blend of science and art. SRIs provide clinically significant relief to most patients, but they are not effective in all patients. Because significant number of patient with OCD do not respond to adequate trials of SRIs, other treatment options such as augmentation, switching, combination, or neurosurgical and device-based approaches may be needed. In this paper, the first-line treatment options and several alternative treatment options for OCD were reviewed. Finally, we reviewed several treatment guidelines and algorithm for OCD introduced previously by other researchers. We have a plan to develop Korean treatment algorithm for OCD based on expert's opinions. Also, we hope to use this algorithm for OCD in the clinical setting in near future.