title: Aripiprazole augmentation in managing comorbid obsessive-compulsive disorder and bipolar disorder: a case with suicidal attempts.
abstract: Comorbid obsessive-compulsive disorder (OCD) and bipolar disorder (BD) have long been an intractable problem in clinical practice. The increased risk of manic/hypomanic switch hinders the use of antidepressants for managing coexisting OCD symptoms in BD patients. We herein present a case of a patient with BD-OCD comorbidity, who was successfully treated with mood stabilizers and aripiprazole augmentation. The young female patient reported recurrent depressive episodes and aggravating compulsive behaviors before hospitalization. Of note, the patient repetitively attempted suicide and reported dangerous driving because of intolerable mental sufferings. The preexisting depressive episode and OCD symptoms prompted the use of paroxetine, which consequently triggered the manic switching. Her diagnosis was revised into bipolar I disorder. Minimal response with mood stabilizers prompted the addition of aripiprazole (a daily dose of 10 mg), which helped to achieve significant remission in emotional and obsessive-compulsive symptoms. This case highlights the appealing efficacy of a small dose of aripiprazole augmentation for treating BD-OCD comorbidity. Well-designed clinical trials are warranted to verify the current findings.
authors.affiliation: Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine; The Key Laboratory of Mental Disorder's Management in Zhejiang Province.
authors.forename: Jianbo
authors.initials: J
authors.lastname: Lai
authors.affiliation: Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine.
authors.forename: Qiaoqiao
authors.initials: Q
authors.lastname: Lu
authors.affiliation: The Key Laboratory of Mental Disorder's Management in Zhejiang Province; Department of Psychiatry, Mental Health Centre, Xiaoshan Hospital of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.affiliation: The Key Laboratory of Mental Disorder's Management in Zhejiang Province; Department of Psychiatry, Mental Health Centre, Xiaoshan Hospital of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Xu
authors.affiliation: Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine; The Key Laboratory of Mental Disorder's Management in Zhejiang Province.
authors.forename: Yi
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine; The Key Laboratory of Mental Disorder's Management in Zhejiang Province.
authors.forename: Shaohua
authors.initials: S
authors.lastname: Hu
keywords: aripiprazole; bipolar disorder; obsessive–compulsive disorder; suicide