Unified protocol for the discontinuation of long-term serotonin reuptake inhibitors in obsessive compulsive disorder: Study protocol and methods

Contemp Clin Trials. 2018 Feb:65:157-163. doi: 10.1016/j.cct.2017.12.017. Epub 2018 Jan 3.


Obsessive-compulsive disorder (OCD) is chronic psychiatric disorder associated with high rates of functional impairment and decreased quality of life. Although serotonin reuptake inhibitors have demonstrated efficacy in the treatment of OCD, little data is available to guide clinicians on how to manage these medications long-term. Cognitive-behavioral approaches provide a promising avenue for helping OCD patients discontinue maintenance SRIs while minimizing the potential for symptom worsening. This manuscript describes the rationale and methods for pilot feasibility study designed to a unified, cognitive-behavioral strategy for discontinuing long-term SRIs in OCD. The aims of the study are (1) to evaluate the feasibility and acceptability of research procedures and interventions, (2) to test the efficacy of this treatment relative to an enhanced control condition and (3) to investigate the role of distress tolerance in both taper completion and clinical outcome. Our central aim is to investigate whether this approach improves discontinue outcomes relative to an enhanced control condition. Identifying optimal long-term treatment strategies for this population is needed to guide clinicians managing this often-chronic disorder.

Keywords: Anxiety; Medication; Obsessive compulsive disorder; Taper.

Publication types

  • Clinical Trial Protocol
  • Clinical Trial, Phase I
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Cognitive Behavioral Therapy / methods*
  • Female
  • Humans
  • Male
  • Obsessive-Compulsive Disorder / epidemiology
  • Obsessive-Compulsive Disorder / therapy*
  • Pilot Projects
  • Quality of Life
  • Research Design
  • Selective Serotonin Reuptake Inhibitors / administration & dosage
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Stress, Psychological / epidemiology


  • Serotonin Uptake Inhibitors