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Generalized anxiety disorder
0%
0/7
Obsessive-compulsive disorder
57%
4/7
Bulimia nervosa
14%
1/7
Bipolar disorder
Schizophrenia
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Clomipramine, a tricyclic antidepressent (TCA) is most commonly used as a second-line treatment for obsessive-compuslive disorder (OCD). OCD consists of two components: recurring, intrusive thoughts that cause severe distress and impairment (obsessions), and the performance of repetitive actions in an attempt to neutralize these obsessions (compulsions). First line treatment for OCD is typically selective-serotonin reuptake inhibitors (SSRIs), which are much safer than TCAs. Cognitive behavioral therapy has also shown to be helpful in OCD patients. Feinberg writes that clomipramine is somewhat unique among TCAs mechanistically in that it acts with high potency on serotonergic neurotransmission, as opposed to typical norepinephrine transmission. Clomipramine is typically tolerated well, but unwanted anticholinergic effects can be observed. Ferrao et al. outline growing evidence that Tourette's syndrome (TS) and trichotillomania (TTM) belong on an obsessive-compulsive spectrum disorder. Several studies have demonstrated a close relationship between TS and OCD, including psychopharmacological research that indicates that TTM, like OCD, responds more robustly to clomipramine than to desipramine. Illustration A depicts a chart containing various TCAs and their relative selectivity. Incorrect Answers: Answer 1, 3-5: Clomipramine is not a first- or second-line agent for treatment of these disorders.
4.3
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