American Board of Psychiatry and Neurology (ABPN) Practice Exam 2026 - Free ABPN Practice Questions and Study Guide

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Which tricyclic antidepressant has shown significantly better efficacy in treating obsessive-compulsive disorder compared to others?

Desipramine

Doxepin

Clomipramine

Clomipramine is recognized for its significant efficacy in treating obsessive-compulsive disorder (OCD) due to its potent serotonin reuptake inhibition. It is a tricyclic antidepressant that specifically enhances serotonergic activity, which is crucial because the pathophysiology of OCD is believed to involve dysregulation in serotonin pathways. Clinical studies have consistently shown that clomipramine is more effective than other tricyclics in alleviating the symptoms of OCD.

While other tricyclic antidepressants, such as desipramine, doxepin, and nortriptyline, also have antidepressant effects, they do not have the same level of evidence supporting their use in OCD treatment. This difference in efficacy makes clomipramine the preferred tricyclic for patients specifically diagnosed with OCD.

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Nortriptyline

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