Risperidone augmentation of specific serotonin reuptake inhibitors in the treatment of refractory obsessive-compulsive disorder: report of two cases.
The efficacy of specific serotonin reuptake inhibitors (SSRI) in the treatment of obsessive-compulsive disorder (OCD) has been established, but more than 40% of patients continue to have a poor response to SSRI. Low-dose antipsychotic augmentation of SSRI has contributed to the amelioration of symptoms in the treatment of refractory obsessive-compulsive disorder patients. Due to the risk of side effects from traditional antipsychotics, atypical novel antipsychotic augmentation of SSRI may be a good choice in the treatment of refractory obsessive-compulsive disorder. Herein we report our experience with two OCD patients, one with a poor response to fluoxetine 80 mg per day for 3 months, and the other with poor response to fluoxetine 60 mg per day for 3 months. Both OCD patients also proved to have a poor response to paroxetine 60 mg per day for 6 weeks. Neither patient had received any psychotherapy or behavioral therapy. Both patients showed significant improvement in their obsessive-compulsive symptoms as measured by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), after risperidone 1 mg per day was added to their on-going use of paroxetine 60 mg per day. Within 4 weeks of adding risperidone, the two patients' Y-BOCS scores had decreased by 57% and 53%. This result suggests that risperidone augmentation of SSRI may be a good choice and an effective treatment strategy for refractory OCD.
Sun
T F
TF
Department of Psychiatry, Chang Gung Memorial Hospital, 123, Ta-Pei Road, Niaosung, Kaohsiung, Taiwan, R.O.C.
Lin
P Y
PY
Wu
C K
CK
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy*; D018967:Risperidone / Q000008:administration & dosage*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*
D014150:Antipsychotic Agents; D018967:Risperidone; D017367:Selective Serotonin Reuptake Inhibitors