Beneficial effect of olanzapine in schizophrenic patients with obsessive-compulsive symptoms

• Published in: International clinical psychopharmacology Vol. 15; no. 3; p. 169
• Main Authors: Poyurovsky, M, Dorfman-Etrog, P, Hermesh, H, Munitz, H, Tollefson, G D, Weizman, A
• Format: Journal Article
• Language: English
• Published: England 01-05-2000
• Subjects: Adult; Antipsychotic Agents - pharmacology; Antipsychotic Agents - therapeutic use; Benzodiazepines; Female; Humans; Male; Middle Aged; Obsessive-Compulsive Disorder - drug therapy; Obsessive-Compulsive Disorder - etiology; Pirenzepine - analogs & derivatives; Pirenzepine - pharmacology; Pirenzepine - therapeutic use; Schizophrenia - complications; Severity of Illness Index; Treatment Outcome
• ISSN: 0268-1315
• DOI: 10.1097/00004850-200015030-00006

Some studies suggest that obsessive-compulsive symptoms may be common (7.8-46%) in schizophrenic patients and seem to be poorly responsive to drug therapy. Conventional neuroleptics are of limited value, but adjunctive anti-obsessive agents (clomipramine, fluvoxamine) may be an option. Although novel atypical antipsychotics (clozapine, risperidone) reportedly aggravate the obsessive-compulsive symptoms, a recent trial has shown that olanzapine did not induce new-onset obsessive-compulsive symptoms in schizophrenic patients. We report our experience with three schizophrenic patients with obsessive-compulsive symptoms who were unsuccessfully treated with various conventional neuroleptics in combination with anti-obsessive agents and subsequently showed resistance or intolerance to clozapine. All of them were switched to olanzapine (10-20 mg/ day). All patients demonstrated a significant improvement in both schizophrenic and obsessive-compulsive symptoms as measured by the Brief Psychiatric Rating Scale (BPRS) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Within 5-8 weeks of initiation of olanzapine, the BPRS scores of the three patient decreased by 53%, 51% and 48%, and the Y-BOCS scores by 68%, 73% and 85%. Olanzapine was well tolerated. These preliminary results suggest that olanzapine may be a therapeutic option in schizophrenic patients with obsessive-compulsive symptoms.