ArticleCureus2024
Efficacy of Supratherapeutic Duloxetine Combined With Cognitive-Behavioral Therapy in Severe Treatment-Resistant Obsessive-Compulsive Disorder With Comorbid Depression: A Case Report.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This case report discusses the treatment of a 42-year-old male with over a decade of treatment-resistant obsessive-compulsive disorder (OCD) and comorbid major depressive disorder (MDD). The patient underwent various pharmacological and psychotherapeutic treatments, including multiple antidepressants and cognitive-behavioral therapy (CBT), yet experienced only partial symptom relief. At baseline, the patient's depressive symptoms were severe, with a Hamilton Depression Rating Scale (HAM-D) score of 28, and his obsessive-compulsive symptoms were marked, with a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score of 34. Due to the chronicity and severity of symptoms, his treatment plan was adjusted to include a high dose of duloxetine, a serotonin-norepinephrine reuptake inhibitor (SNRI), which was gradually titrated to 180 mg/day with close monitoring. Within weeks of this dose adjustment, the patient experienced significant improvements in both depressive and obsessive-compulsive symptoms. The patient sustained these improvements over six months, reporting enhanced functional capacity and quality of life with minimal side effects, with his HAM-D and Y-BOCS scores reduced to 8 and 12, respectively. This case highlights the potential benefits of high-dose duloxetine in complex, treatment-resistant cases and underscores the value of combining pharmacotherapy with CBT to achieve durable outcomes. The report adds to emerging evidence suggesting that supratherapeutic dosing of SNRIs may be a valuable option for patients unresponsive to standard treatments. Further research is encouraged to evaluate the broader applicability and safety of this approach.
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Registered trials
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