Scrupulosity
Little evidence is available on the use of medications to treat scrupulosity. Although serotonergic medications are often used to treat OCD, studies of pharmacologic treatment of scrupulosity in particular have produced so few results that even tentative recommendations cannot be made.
Besipirdine
Besipirdine was originally suggested as a treatment for OCD due to its effects on the adrenergic and serotonergic systems. "In vitro" studies of besipirdine indicated its potency in inhibiting serotonin reuptake in addition to norepinephrine reuptake. "In vivo", besipirdine showed efficacy in reducing schedule-induced polydipsia (SIP) in rats. The drug's anticonvulsant properties ultimately led Hoechst AG to pursue it as a treatment for Alzheimer's disease.
After its discontinuation in the mid-90's, besipirdine was re-evaluated as an oral treatment for Over Active Bladder (OAB) and is currently undergoing Phase III clinical trials, under UroGene. Interest in besipirdine as a treatment for OAB was piqued by its known effects on the adrenergic system. In isolated studies, besipirdine showed greater potency than duloxetine on bladder capacity, micturition volume, intercontraction interval, and an increase in striated sphincter EMG activity.