Abstract:
Obsessive-compulsive disorder (OCD) is a severe psychiatric
illness that is difficult to treat. The effects of trazodone
hydrochloride treatment were studied, both with and without the addition
of a monoamine oxidase inhibitor, in OCD patients. Changes in symptoms
correlated with changes in local cerebral metabolic rates for glucose
(LCMRGlc), as measured by positron emission tomography and the 18F-
fluorodeoxyglucose method. All patients whose OCD responded favorably to
drug treatment showed a relative increase in glucose metabolism in the
heads of the caudate nuclei compared with the metabolic rate in the
ipsilateral hemisphere as a whole (ratio LCMRGlc caudate/LCMRGlc
hemisphere). Patients who did not respond to treatment did not show an
increase in this ratio, and the difference between responders and
nonresponders was significant (p less than 0.03). Changes in the ratio
LCMRGlc caudate/LCMRGlc hemisphere correlated with changes on OCD and
depression rating scales