Limitations
sleep disturbance, OCD, treatment-resistant OCD
Our study was limited by small sample size, short duration, not including patients with comorbidities, and high attrition rate (23.07%). Additionally, we only included patients with moderate to severe OCD, and our results are not generalizable to patients with treatment-resistant OCD. Further multi-center clinical trials with extended follow‑up period and large sample size are needed to assess the effect of agomelatine on OCD symptoms. We also suggest including patients with treatment-resistant OCD, sleep disturbance and other comorbidities.