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Adverse Reactions anticholinergic antiobsessional anxiety Arch Gen Psychiatry assessment atric baseline behavior benzodiazepines chiatry chronically mentally ill clinician clomipramine CMHCs community mental health Community Psychiatry deinstitutionalization Department of Psychiatry depressed patients develop diagnosis discontinuation dosage dose double-blind drug evaluation fluoxetine fluvox fluvoxamine HALCION Hosp Community hospital impairment improvement increased inhibitor Insel insomnia ment Mental Health Centers mentally ill Navane neuroleptic nortriptyline obses obsessional Obsessive Compulsive Disorder obsessive-com obsessive-compulsive obsessive-compulsive disorder occur OCD patients OCD symptoms overdosage patients receiving placebo potential Protocol 59 Prozac psychia psychiatrist psychosocial pulsive disorder rating scales rehabilitation reported response reuptake role schizophrenia score SD seclusion and restraint seizures serotonin sexual side effects significant SINEQUAN sion staff studies syndrome tardive dyskinesia thera therapeutic therapist therapy thiothixene tion tional treat treatment boundaries treatment of obsessive tricyclic antidepressants trist XANAX Y-BOCS score