Patients:

Inclusion Criteria:

• Aged 18-55
• Good physical health
• Able to discontinue all medications except a benzodiazepine if necessary
• OCD of moderate or greater severity for at least one year
• Failed to benefit markedly from at least two adequate (at least 8 week) trials of serotonin reuptake inhibitors: citalopram 20 mg/day; clomipramine 200 mg/day; fluoxetine 40 mg/day; fluvoxamine 200 mg/day; paroxetine 40 mg/day; sertraline 100 mg/day.

Exclusion Criteria:

• Psychotic disorder
• Substance or alcohol abuse/dependence diagnosis within the previous six months
• History of bipolar disorder
• Tic disorder or Tourette's syndrome
• Personality disorder severe enough to interfere with cooperation with the study procedures

Healthy Controls:

None

What Will Subjects Do?

Study patients will receive, double-blind, either intravenous or oral clomipramine on two consecutive days: 150 mg on Day 1 and 200 mg on Day 2, administered in the Stanford General Clinical Research Center (inpatient unit), with continuous monitoring of vital signs. On the fourth day after completing the pulse loading, the patient will come to the Psychiatry outpatient clinic to begin 12 weeks of oral clomipramine, starting at 200 mg/day and increasing rapidly, as tolerated, to 250 mg/day. Patients who cannot come to Stanford for regular weekly visits must be at Stanford for one week at the beginning of the study and one day at the end of the study. The 12 weeks of open-label oral clomipramine treatment can be completed in the patient's home city with the assistance of the patient's usual treating psychiatrist.

Subjects Needed:

Characteristic Subjects: 38 (at Stanford), plus 38 (University of Cincinatti)

Healthy Subjects: 0

If you would like to participate in this study, whether or not you think you qualify, please click the Sign Up button below, and let us know of your interest.