Clomipramine treatment of obsessive compulsive symptomatology in schizophrenic patients.
BACKGROUND
Schizophrenic patients with obsessive compulsive symptoms have poor prognoses. Clomipramine is an effective antiobsessional agent, but its possible antiobsessional effect in schizophrenic patients with obsessive compulsive symptoms who are taking neuroleptics has not been studied.


METHODS
We conducted an open pilot study in which we added clomipramine to ongoing neuroleptic regimens of five chronic DSM-III-R schizophrenic (N = 3) or schizoaffective (N = 2) patients who were consecutively admitted for treatment during an active phase. Clomipramine treatment was subsequently discontinued in two patients (off-on-off design), whereas it was discontinued and then reinstituted in three patients (off-on-off-on design).


RESULTS
All five patients had substantial reductions in previously persistent obsessive compulsive symptoms, and all experienced relapse of their obsessive compulsive symptoms after clomipramine treatment cessation. In the three patients for whom the authors were able to reinstitute clomipramine, an improvement in obsessive compulsive symptoms was noticed once again. Only one patient had an exacerbation of her psychosis with the combined treatment.


CONCLUSIONS
The addition of clomipramine, a serotonin reuptake blocker, to ongoing neuroleptic treatment in schizophrenic patients with obsessive compulsive symptoms was associated with specific reductions of those symptoms. Further studies of antiobsessional agents in selected schizophrenic patients appear warranted.
Zohar
J
J
Division of Psychiatry, Chaim Sheba Medical Center, Ramat Gan, Tel-Hashomer, Israel.
Kaplan
Z
Z
Benjamin
J
J
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002997:Clomipramine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000523:psychology; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy / Q000523:psychology; D012008:Recurrence; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D002997:Clomipramine