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It is the most 5-HT-selective among SSRIs, with little or no affinity for other transmitter transporters or receptors [59]. Compared to other SSRIs, escitalopram may have weak or minimal interactions with the cytochrome P450 system [60, 61]. In a randomized, double-blind, placebo-controlled 24-week trial in OCD, escitalopram (20 mg/day) was associated with an increase in response rate compared to placebo after 12 weeks. Other placebo-controlled studies consistently showed escitalopram-related treatment response [25, 30]. 20 mg/day escitalopram has also been associated with better OCD symptom remission compared to 40 mg/day paroxetine or placebo at week 12 [30]. 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