SUMMARY

Twelve subjects with a diagnosis of Obsessive Compulsive Disorder who had not shown response to amit-ryptiline and imipramine/behaviour therapy underwent a cross over double blind trial with clomipramine and nortryptiline. Subjects who had earlier not shown response to the other drugs did not show response to clomip-ramine. The implications of these findings for clinical management are discussed. Clomipramine has been widely recog-nised as the drug of choice for obsessive compulsive disorder (OCD) whose effi-cacy has been shown in various double blind studies (Thoren et al 1980, Marks et al 1980, Montgomery 1980, Ananth et al 1981, Insel et al 1983). However, it has been suggested that about one third of pa-tients do not respond to pharmacotherapy (Insel 1985). Higher cerebrospinal fluid 5-hydroxy indole acetic acid has been show