The role of venlafaxine in the treatment of obsessive-compulsive disorder

Objective: To evaluate the published literature regarding the use of venlafaxine in the treatment of obsessive-compulsive disorder (OCD). Data Sources: MEDLINE (1996-March 2004) and International Pharmaceutical Abstracts (1970-March 2004) were searched using the terms venlafaxine and obsessive-compulsive disorder. A bibliographic search was conducted as well. Data Synthesis: Successful treatment of OCD with venlafaxine has been reported in case reports, open trials, and blinded trials versus active comparators. The only placebo-controlled trial did not find statistically significant improvement with venlafaxine treatment; however, methodologic limitations may have influenced those results. Venlafaxine appears to be as efficacious as clomipramine, but is preferable to this agent in terms of safety and tolerability. Venlafaxine seems to be similar to paroxetine with respect to both therapeutic effects and adverse effects, but may be inferior to paroxetine when used for nonresponders to previous serotonin-reuptake inhibitor therapy. Conclusions: Although the relative scarcity of data precludes definitive conclusions, available evidence suggests that venlafaxine is effective and well tolerated in the treatment of OCD. Unfortunately, it has not shown any unique advantages relative to currently available medications.