In a paper published on-line in advance of publication in the Journal of Psychiatric Research, Sanjaya Saxena, M.D., Director of the Obsessive-Compulsive Disorders (OCD) Program at the University of California, San Diego (UCSD) School of Medicine, reports the surprising finding that the serotonin reuptake inhibitor (SRI) medication, paroxetine, is effective in treating patients with compulsive hoarding syndrome.
The study of 79 patients diagnosed with obsessive-compulsive disorder (OCD) - 32 of them with compulsive hoarding syndrome - suggests that further controlled trials of SRI medications for compulsive hoarding are now warranted.
Compulsive hoarding, which may affect up to 2 million people in the United States, is found in people with many diseases, including anorexia, schizophrenia, Alzheimer's disease and dementia. It is most often found in patients with OCD, though researchers are not yet sure if it is a subtype of OCD or a separate disorder.
In previous, retrospective studies - looking at patients and data from past drug trials - compulsive hoarding had been associated with poor response to SRI medications commonly used to treat OCD patients. However, no previous study had ever directly tested this widely held theory. Saxena's prospective study, comparing the hoarding and non-hoarding OCD patients, showed nearly identical responses to paroxetine (commonly known as Paxil.) The symptoms exhibited by patients in both groups improved significantly with treatment.
Compulsive hoarding patients exhibit three core features: failure to discard objects due to severe anxiety related to discarding what most might regard as inconsequential objects; excessive acquisition, sometimes resulting in buying sprees; and excessive clutter to the point where home and work spaces can no longer be used. They also display marked indecisiveness, disorganization, and procrastination. Sometimes such patients are only discovered when a landlord, social worker or fireman enters a home in which every available surface - floors, tables, sofas and beds - is covered with clutter making the space inhabitable.
"The syndrome is driven by obsessional fears of not having items you might need, or of losing something valuable, as well as overly sentimental attachments to objects." said Saxena.