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. 2023 Feb;24(2):118-134.
doi: 10.1080/15622975.2022.2086296. Epub 2022 Jul 28.

World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders - Version 3. Part II: OCD and PTSD

Borwin Bandelow  1 , Christer Allgulander  2 , David S Baldwin  3 , Daniel Lucas da Conceição Costa  4 , Damiaan Denys  5 , Nesrin Dilbaz  6 , Katharina Domschke  7 , Eric Hollander  8 , Siegfried Kasper  9 , Hans-Jürgen Möller  10 , Elias Eriksson  11 , Naomi A Fineberg  12 , Josef Hättenschwiler  13 , Hisanobu Kaiya  14 , Tatiana Karavaeva  15   16 , Martin A Katzman  17   18   19   20 , Yong-Ku Kim  21 , Takeshi Inoue  22 , Leslie Lim  23 , Vasilios Masdrakis  24 , José M Menchón  25 , Euripedes C Miguel  26 , Antônio E Nardi  27 , Stefano Pallanti  28 , Giampaolo Perna  29 , Dan Rujescu  30 , Vladan Starcevic  31 , Dan J Stein  32 , Shih-Jen Tsai  33 , Michael Van Ameringen  34 , Anna Vasileva  35 , Zhen Wang  36 , Joseph Zohar  37
Affiliations

World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders - Version 3. Part II: OCD and PTSD

Borwin Bandelow et al. World J Biol Psychiatry. 2023 Feb.

Abstract

Aim: This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders which was published in 2002 and revised in 2008.

Method: A consensus panel of 34 international experts representing 22 countries developed recommendations based on efficacy and acceptability of the treatments. In this version, not only medications but also psychotherapies and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medication treatments.

Result: The present paper (Part II) contains recommendations based on published randomised controlled trials (RCTs) for the treatment of OCD (n = 291) and PTSD (n = 234) in children, adolescents, and adults. The accompanying paper (Part I) contains the recommendations for the treatment of anxiety disorders.For OCD, first-line treatments are selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioural therapy (CBT). Internet-CBT was also superior to active controls. Several second-line medications are available, including clomipramine. For treatment-resistant cases, several options are available, including augmentation of SSRI treatment with antipsychotics and other drugs.Other non-pharmacological treatments, including repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation (DBS) and others were also evaluated.For PTSD, SSRIs and the SNRI venlafaxine are first-line treatments. CBT is the psychotherapy modality with the best body of evidence. For treatment-unresponsive patients, augmentation of SSRI treatment with antipsychotics may be an option.

Conclusion: OCD and PTSD can be effectively treated with CBT and medications.

Keywords: Obsessive-compulsive disorder; children; guideline; posttraumatic stress disorder; treatment.

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