Clonazepam treatment of obsessions and compulsions

Obsessive compulsive disorder has recently been successfully treated with antidepressants that selectively inhibit serotonin reuptake, and a serotonergic hypothesis related to the etiology and treatment of obsessive compulsive disorder has been proposed. Clonazepam, a novel benzodiazepine, uniquely affects serotonergic neurotransmission. It has been employed in the treatment of other neuropsychiatric syndromes that respond to serotonergic medications. Three patients with obsessive compulsive disorder who were treated with clonazepam for periods of up to 1 year experienced substantial improvement in their symptoms. Clonazepam had a rapid onset of antiobsessive action with accompanying decreases in both depression and anxiety. One patient showed reductions in obsessions and compulsions that were equivalent to or greater than those seen during previous treatment with clomipramide. Clonazepam may be a useful alternative to serotonergic antidepressants in patients who cannot tolerate the toxic effects of these medications.