Treatments in obsessive-compulsive disorder: prescribing patterns in Italy.

Objective: the aim of the present study was to investigate the patterns of psychopharmacological prescribing in a large sample (n=1815) of patients suffering from obsessive-compulsive disorder (OCD) referred to four Italian centres specialized in OCD, in comparison to available national and international guidelines. Methods: the centres of Turin, Milan and Rome were selected on the basis of their expertise in treating OCD by the coordinating centre (Pisa), and all completed a specific data sheet questionnaire about the therapeutic status of their patients. Results: almost all patients referred to the centres of Milan, Pisa and Rome received psychotropic medications. Only 60% received medications in Turin. Selective serotonin reuptake inhibitors (SSRIs) were the most used drugs in all four centres. Clomipramine and other tricyclic antidepressants were more often prescribed in Rome and Pisa. Second-generation antipsychotics were more often prescribed in Pisa and in Milan. Mood stabilizers were almost exclusively prescribed in Pisa. Conclusions: although the Italian centres follow the available guidelines for the pharmacological treatment of OCD, a certain degree of variability in prescriptions does exist. This may depend on the different educational background, availability of other specific therapeutic strategies, as well as varying levels of severity and comorbidity of patients