title: Antiserotonergic antipsychotics are associated with obsessive-compulsive symptoms in schizophrenia.
abstract: BACKGROUND
  Epidemiological investigations show that up to 30% of schizophrenic patients suffer from obsessive-compulsive symptoms (OCS) associated with negative impact on the general prognosis. It has been proposed that antiserotonergic second-generation antipsychotics (SGAs) might induce OCS, but investigations of large samples integrating psychopathology, neuropsychology and psychopharmacology are missing.
  
  
  METHODS
  We stratified 70 patients with schizophrenia according to their mode of antipsychotic treatment: clozapine and olanzapine (group I) compared with aripiprazole and amisulpride (group II). The groups were matched according to age, sex, educational levels and severity of the psychotic disorder (Positive and Negative Syndrome Scale). As the primary endpoint, we evaluated OCS severity (Yale-Brown Obsessive-Compulsive Scale).
  
  
  RESULTS
  OCS were significantly more prevalent and severe in group I, in which OCS severity correlated with dosage of clozapine and duration of treatment. Pronounced cognitive deficits in group I were found in visuospatial perception and visual memory (Wechsler Adult Intelligence Scale-Revised block design, Rey-Osterrieth Complex Figure Test), impulse inhibition (go/no-go test), higher perseveration scores (Wisconsin Card Sorting Test) and reduced set-shift abilities (Trail Making Test Part B, Set-shift Task). These cognitive domains correlated with OCS severity.
  
  
  CONCLUSIONS
  OCS in schizophrenia are associated with antiserotonergic SGA treatment, but longitudinal studies have to prove causality. Before starting treatment with antiserotonergic SGAs, specific neurocognitive domains should be evaluated, as visuospatial learning and impulse inhibition performance might allow early detection of OCS secondary to antipsychotic treatment in schizophrenia.
authors.affiliation: Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Mannheim, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Schirmbeck
authors.forename: C
authors.initials: C
authors.lastname: Esslinger
authors.forename: F
authors.initials: F
authors.lastname: Rausch
authors.forename: S
authors.initials: S
authors.lastname: Englisch
authors.forename: A
authors.initials: A
authors.lastname: Meyer-Lindenberg
authors.forename: M
authors.initials: M
authors.lastname: Zink
mesh_terms: D000328:Adult; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000009:adverse effects*; D000068180:Aripiprazole; D001569:Benzodiazepines / Q000009:adverse effects; D003024:Clozapine / Q000009:adverse effects; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D009771:Obsessive-Compulsive Disorder / Q000139:chemically induced* / Q000453:epidemiology; D000077152:Olanzapine; D010879:Piperazines / Q000009:adverse effects; D015995:Prevalence; D015363:Quinolones / Q000009:adverse effects; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D012702:Serotonin Antagonists / Q000009:adverse effects*; D012720:Severity of Illness Index; D013469:Sulpiride / Q000009:adverse effects / Q000031:analogs & derivatives
chemical_list: D014150:Antipsychotic Agents; D010879:Piperazines; D015363:Quinolones; D012702:Serotonin Antagonists; D001569:Benzodiazepines; D013469:Sulpiride; D000077582:Amisulpride; D000068180:Aripiprazole; D003024:Clozapine; D000077152:Olanzapine