A randomized, open-label pilot trial of selective serotonin reuptake inhibitors on neuropsychological functions in patients with obsessive compulsive disorder

Abstract

BackgroundThere is enough empirical literature suggesting impairments in neuropsychological functioning in patients with obsessive compulsive disorder (OCD) despite inconsistencies. AimThe aim of the index study was to study the effect of Selective Serotonin Reuptake Inhibitors (SSRIs) on neuropsychological functions and illness severity in drug-naïve subjects with OCD. MethodsA total of 50 subjects with diagnosis of obsessive-compulsive disorder (DSM-5) in the age range of 18–55 years, drug naïve, without comorbid depression/anxiety disorders were randomized to receive either Sertraline or Fluvoxamine. Neuropsychological functions and severity of illness were evaluated using NIMHANS neuropsychological battery and Y-BOCS at baseline and 12 weeks posttreatment with SSRIs. ResultsAt baseline, study subjects had moderate severity of OCD and neuropsychological functions were impaired in a substantial number of subjects. More than half of the subjects were having impairment in verbal fluency and category fluency i.e., executive function impairment; the scores for DSST, DVT (assessing mental speed and sustained attention), Verbal N Back 1 error (assessing verbal working memory) WCST total trials (assessing set shifting) were found to be significantly correlated with Y-BOCS score i.e. severity of illness. Significant improvement was observed in both the illness severity and neuropsychological functions at end point. The proportion of adequate performers on various neuropsychological tests increased significantly at 12 weeks. ConclusionA substantial number of patients with OCD have neuropsychological impairments, however, the pattern of impairments does not follow any sequence. Adequate management of OCD with SSRIs leads to improvement in both illness severity and neuropsychological functions in the short term.