Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part I: pharmacological treatment.

31 - 37 A network meta-analysis showed that a nonsignificant trend favoring clomipramine disappeared when the sensitivity analysis accounted for the attrition rates observed in the clinical trials testing serotonergic medications – clomipramine studies, conducted earlier than those testing SSRIs, reported data only for subjects who completed the trials, overestimating efficacy despite lower rates of effectiveness.

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63 , 64 , 66 Though this RCT showed a trend favoring paliperidone as an augmentation strategy, there was no significant superiority of adjunctive paliperidone over placebo. 66 The COR for this augmentation strategy is 3 (no benefit) and the LOE is B-R.

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