Remission Rates at Week 24: Sertraline vs Fluoxetine for OCD
Sertraline demonstrates superior remission rates compared to fluoxetine at week 24 for OCD treatment, with 36% of sertraline-treated patients achieving remission versus 22% for fluoxetine (p = 0.075). 1
Direct Head-to-Head Comparison
The most relevant evidence comes from a double-blind, 6-month comparative trial specifically examining OCD treatment outcomes:
- Sertraline remission rate at week 24: 36% (defined as CGI-I ≤2 and Y-BOCS score ≤11) 1
- Fluoxetine remission rate at week 24: 22% (same criteria) 1
- This represents a 64% relative increase in remission likelihood with sertraline 1
Earlier Treatment Response Advantages
Sertraline also demonstrated faster onset of clinical benefit:
- At week 12, sertraline achieved 20% remission versus 8% for fluoxetine (p = 0.047), showing statistically significant superiority at the midpoint 1
- By week 12,49.2% of sertraline patients were rated as "mildly ill or not ill" on CGI-Severity compared to only 24.6% on fluoxetine (p < 0.01) 1
- Cox analysis showed sertraline patients had a 42% greater likelihood of achieving response by week 12, though this did not reach statistical significance (p = 0.18) 1
Clinical Significance
Both medications demonstrated equivalent and significant improvement on Y-BOCS scores by week 24 (p < 0.001), but sertraline's advantage lies in achieving full remission rather than just response. 1 This distinction is critical for long-term outcomes, as remission (not just response) predicts better functional recovery and lower relapse rates in OCD.
Tolerability Context
Both medications were well-tolerated throughout the 24-week study period, with no significant differences in discontinuation rates due to adverse events 1. This comparable tolerability profile means the remission rate advantage of sertraline is not offset by tolerability concerns.