ABSTRACT

Novartis Pharmaceuticals Corporation It has now been more than a decade since the initiation of the first industry-sponsored, multicenter, clinical investigations of a pharmacologic treatment for obsessive-compulsive disorder (OCD). This clinical development program was conceived in early 1986 and that summer the clinical trials were begun, under the sponsorship of CIBA-Geigy. At that time, because of very limited availability of effective treatments, it was difficult to successfully treat OCD. Behavioral therapy was an option for some patients, and a variety of pharmacologic approaches had been tried with varying degrees of success, but in the 1980s no medication had yet received U.S. Food and Drug Administration approval for treatment of OCD. Indeed, it is no exaggeration to say that OCD was mainly regarded at that time as a treatment-refractory disorder. It is, therefore, a privilege to be able to review here the development of the first drug approved in the United States for the treatment of OCD, and to know that the approval of clomipramine, and other drugs that followed, has contributed to a change in status for this disorder, from a mainly treatment-refractory to a mainly treatable condition.