Successful treatment for obsessive-compulsive disorder with addition of low-dose risperidone to fluvoxamine: implications for plasma levels of catecholamine metabolites and serum brain-derived neurotrophic factor levels.
The authors report on the successful treatment of obsessive-compulsive disorder (OCD) in three patients with the addition of risperidone to ongoing fluvoxamine treatment. Plasma homovanillic acid (HVA), but not 3-methoxy-4-hydroxyphenylglycol (MHPG) levels decreased after risperidone administration, and plasma levels of fluvoxamine did not change. In addition, serum brain-derived neurotrophic factor (BDNF) levels were not altered after the recovery from obsessive-compulsive symptoms, indicating that serum BDNF levels might not predict the patient's response to risperidone treatment. Taken together, a combination treatment of risperdone and fluvoxamine might improve obsessive-compulsive symptoms. In short, fluvoxamine enhances the activity of the serotonergic system by inhibiting serotonin transporters, and risperidone decreases that of the dopaminergic system by blocking D2 receptors.
Yoshimura
Reiji
R
Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan. yoshi621@med.uoeh-u.ac.jp
Kaneko
Sachiko
S
Shinkai
Koji
K
Nakamura
Jun
J
D000328:Adult; D014150:Antipsychotic Agents / Q000097:blood / Q000627:therapeutic use*; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D002395:Catecholamines / Q000378:metabolism*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D016666:Fluvoxamine / Q000097:blood / Q000627:therapeutic use*; D006719:Homovanillic Acid / Q000097:blood; D006801:Humans; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000097:blood; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy*; D018967:Risperidone / Q000097:blood / Q000627:therapeutic use*; D012702:Serotonin Antagonists / Q000097:blood / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000097:blood / Q000627:therapeutic use*
D014150:Antipsychotic Agents; D019208:Brain-Derived Neurotrophic Factor; D002395:Catecholamines; D016666:Fluvoxamine; D006719:Homovanillic Acid; D008734:Methoxyhydroxyphenylglycol; D018967:Risperidone; D012702:Serotonin Antagonists; D017367:Selective Serotonin Reuptake Inhibitors