Risperidone augmentation in refractory obsessive-compulsive disorder: an open-label study

• Published in: International clinical psychopharmacology Vol. 15; no. 5; p. 297
• Main Authors: Pfanner, C, Marazziti, D, Dell'Osso, L, Presta, S, Gemignani, A, Milanfranchi, A, Cassano, G B
• Format: Journal Article
• Language: English
• Published: England 01-09-2000
• Subjects: Adult; Antipsychotic Agents - administration & dosage; Antipsychotic Agents - therapeutic use; Bipolar Disorder; Comorbidity; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Obsessive-Compulsive Disorder - drug therapy; Obsessive-Compulsive Disorder - psychology; Recurrence; Risperidone - administration & dosage; Risperidone - therapeutic use; Serotonin Uptake Inhibitors - administration & dosage; Treatment Outcome
• ISSN: 0268-1315
• DOI: 10.1097/00004850-200015050-00007

Risperidone, an atypical neuroleptic, has been proposed for augmentation strategies in resistant obsessive-compulsive disorder (OCD). We report the results of an open-label trial on the use of the combination of serotonin reuptake inhibitors (SRIs) with risperidone in 20 refractory OCD outpatients. All patients had been suffering from OCD, according to DSM-IV criteria, for at least 2 years and had various comorbid disorders. All had been treated with a SRI at adequate dosages for at least 6 months, but had failed to respond. Therefore, risperidone was added and the dosage titrated up to the mean dose of 3 mg/day over 8 weeks. After 2 months of this regimen, all patients had shown a reduction in obsessive-compulsive symptoms, as assessed by the decrease in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) total score, particularly those with a lifetime comorbidity with bipolar disorder; only three patients reported mild sedation and postural hypotension, two mild extrapyramidal side-effects (tremors and akatysia) and two an increased appetite. All these effects were well tolerated and no patient halted the treatment. The addition of risperidone would appear to be a useful strategy for augmenting SRI effectiveness in refractory OCD patients.