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Table 2 Clinical and demographic characteristics of SRI-refractory OCD patients treated with agomelatine 50 mg/day for a minimum of 3 months

From: Switching from serotonin reuptake inhibitors to agomelatine in patients with refractory obsessive-compulsive disorder: a 3 month follow-up case series

  Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 Patient 6
Age 35 44 66 53 25 33
Age at onset 23 36 57 20 15 24
Gender M M F F M F
DSM-IV Axis-I comorbidities Resistant MDD, social anxiety disorder Impulse-control disorder, substance abuse disorder None Bulimia nervosa, panic disorder None Panic disorder
First-degree relatives family history Bipolar disorder II (brother) ADHD (son) None None None None
Side effects Weight gain (BMI 32 to 34 within 3 months) None None None None Dizziness (initial, spontaneously remitting)
Last failed SRI trial Fluoxetine 60 mg/day Sertraline 200 mg/day Fluoxetine 60 mg/day Amitriptyline 300 mg/day Fluvoxamine 250 mg/day Duloxetine 120 mg/day + CBT
Main clinical features/OC symptoms Doubt/compulsive shopping Belching compulsion Religious/touching Hoarding/insertion of thought and intrusive images with sexual contents/checking Checking/repeating Fear of losing control toward food (in absence of BED)
Y-BOCS total score (baseline to week 12) Not modified Remission: 21 to 9 Not modified Not modified Remission: 32 to 11 Remission: 22 to 8
Actual, subjective circadian rhythms impairment (BRIAN) Any relevant disruptions Reported stable insomnia Any relevant disruptions Any relevant disruptions Reported daily hypersomnia and nocturnal awakening Any relevant disruptions
Lifetime bipolar spectrum signs (TEMPS-A at week 12) Cyclothymic temperament Anxious temperament Any specific Cyclothymic temperament Any specific Any specific (but presence of PD)
Poor insight feature (BABS, baseline-week 12) No (stable) Yes→No No (stable) No (stable) No (stable) No (stable)
  1. Patient 6 received CBT within the 3 month trial with agomelatine; psychotherapy had already been established at least 6 months earlier.
  2. ADHD = attention deficit hyperactivity disorder; BABS = Brown Assessment of Beliefs Scale; BED = Binge Eating Disorder; BMI = body mass index; BRIAN = Biological Rhythms Interview of Assessment in Neuropsychiatry; CBT = cognitive behavioral therapy; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, fourth edition; MDD = major depressive disorder; SRI = serotonin reuptake inhibitor; OC = obsessive compulsive; PD, panic disorder; TEMPS-A = Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego lifetime Autoquestionnaire; Y-BOCS = Yale-Brown Obsessive Compulsive Scale.