Meta-Analysis of the Dose-Response Relationship of SSRI in Obsessive-Compulsive Disorder

High-dose SSRI pharmacotherapy showed significantly greater improvement in Y-BOCS score than both low-dose (WMD=2.1, p<0.001) and medium-dose (WMD=1.8, p=0.001) SSRI, and higher treatment response rat

Effect: improvement; WMD=3.9 (95% CI: 2.9-4.9) vs placebo for Y-BOCS change; ARD=0.22 (95% CI: 0.16-0.28) for treatment response vs placebo; CI: 95% CI: 2.9-4

Medium-dose SSRI pharmacotherapy failed to show significantly greater improvement in Y-BOCS score or treatment response rate compared to low-dose SSRI pharmacotherapy in the treatment of OCD.

Effect: null; WMD=0.4 (Y-BOCS change); ARD=0.01 (treatment response); CI: 95% CI: -0.5-1.4 (Y-BOCS WMD); 95% CI: -0.06-0.07 (ARD)

SSRI dose was not associated with the proportion of all-cause dropouts in the treatment of OCD, and no dose category differed from placebo or each other.

Effect: null

Higher doses of SSRIs were associated with significantly higher proportion of dropouts due to side effects compared to placebo and low-dose SSRI, though the increased side-effect burden was somewhat c

Effect: adverse; ARD=0.07, NNH=14.3 (high vs placebo); ARD=0.05, NNH=16.7 (high vs low dose); CI: 95% CI: 0.03-0.11, NNH 95% CI: 9.9-50.0 (vs placebo); 95% CI