Table 1.
Controlled and Open-Label SRI Studies in Body Dysmorphic Disordera
| Medication | Study Design | N | Trial Duration and Mean Dose (mg/day) | Resultsb | Reference |
|---|---|---|---|---|---|
| Clomipramine (Anafranil) vs desipramine | Randomized, double blind controlled cross-over trial | 40 entered; 29 randomized | - 16 weeks (8 weeks on each medication) - CMI: 138 ± 87 - DMI: 147 ± 80 |
Clomipramine was significantly more effective than desipramine for BDD symptoms and functional disability; response rate of 65% vs 35% on BDD-YBOCSc | Hollander et al., 1999 |
| Fluoxetine (Prozac) vs placebo | Randomized, double blind, placebo-controlled, parallel group trial | 74 entered; 67 randomized | - 12 weeks - 77.7 ± 8.0 range, 40-80) |
Fluoxetine was significantly more effective than placebo; response rate of 53% vs 18% on BDD-YBOCSd; effect size: d=.70 | Phillips et al., 2002 |
| Fluvoxamine (Luvox) | Open-label trial | 30 | - 16 weeks - 238.3 ± 85.8 (range, 50-300) |
63% of subjects responded to fluvoxamine on BDD-YBOCSd | Phillips et al., 1998 |
| Fluvoxamine (Luvox) | Open-label trial | 15 | - 10 weeks - 208.3 ± 63.4 (range, 100-300) |
10 subjects responded to fuvoxamine on the CGI | Perugi et al., 1996 |
| Citalopram (Celexa) | Open-label trial | 15 | - 12 weeks - 51.3 ± 16.9 (range, 10-60) |
73% of subjects responded to citalopram on BDD-YBOCSd; quality of life and functioning also significantly improved | Phillips and Najjar, 2003 |
| Escitalopram (Lexapro) | Open-label trial | 15 | - 12 weeks - 28.0 ± 6.5 (range, 10-30) |
73% of subjects responded to escitalopram on BDD-YBOCSd; quality of life and functioning also significantly improved | Phillips, 2006 |
Case reports, case series, and retrospective studies are not included in the table but are described in the text
Results are reported for an intent-to-treat analysis for all studies except for the clomipramine/desipramine trial, which used a minimum treatment analysis.
Response was defined as 25% or greater decrease in total BDD-YBOCS score; the BDD-YBOCS (Phillips et al., 1997) assessed BDD severity during the past week based on: (1) preoccupation with the perceived defect (time occupied, interference with functioning due to the preoccupation, distress, resistance, and control), (2) associated compulsive behaviors such as mirror checking (time spent, interference with functioning, distress if the behaviors are prevented, resistance, and control), (3) delusionality/insight, and (4) avoidance.
Response was defined as 30% or greater decrease in total BDD-YBOCS score