title: Treatment with Ziprasidone for schizophrenia patients with OCD.
abstract: Comorbidity of obsessive-compulsive disorder (OCD) has been observed in about 15% of schizophrenic patients and has been associated with poor prognosis. Therefore, there is a need for specific treatment options for these patients (schizo-obsessive, ScOCD). This is an open, prospective study, aiming to test the efficacy of Ziprasidone (80-200mg/d) in ScOCD patients and comparing the response to the treatment between stable schizophrenic (N=16) and stable ScOCD (N=29) patients. Treatment effect with Ziprasidone was different in schizophrenic patients when stratified based on OCD comorbidity. Overall, the effect on OCD symptoms (as measured by the Yale Brown Obsessive Compulsive Scale, YBOCS) was found to be bimodal-either no response or exacerbation (for 45% of the patients, n=13) or significant improvement of symptoms (55%, n=16). Those who improved in OCD symptoms, improved also in negative and general schizophrenia symptoms, while ScOCD-unimproved group worsened in all symptoms. Whereas schizophrenic patients without OCD responded in a modest Gaussian distribution, they improved in schizophrenia negative symptoms and in general anxiety. This data suggests that schizo-obsessive disorder is a distinct and complex condition with more than one underlying pathogenesis. Definition of these ScOCD subgroups defined by their response to Ziprasidone might contribute to personalized medicine within the OCD-schizophrenia spectrum. Moreover, this finding suggests that ScOCD may be considered as a special schizophrenic subtype and its inclusion in schizophrenia treatment studies need to be further explored due to its divergent response.
authors.affiliation: Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. Electronic address: alzbeta.juvenwetzler@sheba.health.gov.il.
authors.forename: Alzbeta
authors.initials: A
authors.lastname: Juven-Wetzler
authors.affiliation: Department of Communication Disorders, Ariel University, Ariel, Israel. Electronic address: leah.fostick@ariel.ac.il.
authors.forename: Leah
authors.initials: L
authors.lastname: Fostick
authors.affiliation: Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. Electronic address: shlomit.cwikelhamzany@sheba.health.gov.il.
authors.forename: Shlomit
authors.initials: S
authors.lastname: Cwikel-Hamzany
authors.affiliation: Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. Electronic address: jennia.balaban@sheba.health.gov.il.
authors.forename: Evgenya
authors.initials: E
authors.lastname: Balaban
authors.affiliation: Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel. Electronic address: joseph.zohar@sheba.health.gov.il.
authors.forename: Joseph
authors.initials: J
authors.lastname: Zohar
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000188:drug therapy*; D010879:Piperazines / Q000627:therapeutic use*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy*; D013844:Thiazoles / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D010879:Piperazines; D013844:Thiazoles; C092292:ziprasidone
keywords: OCD; Personalized medicine; Schizophrenia; Ziprasidone