Dj. Stein et al., RISPERIDONE AUGMENTATION OF SEROTONIN REUPTAKE INHIBITORS IN OBSESSIVE-COMPULSIVE AND RELATED DISORDERS, The Journal of clinical psychiatry, 58(3), 1997, pp. 119-122
Background: While serotonin is the neurotransmitter most commonly impl
icated in obsessive-compulsive and related disorders, there is also ev
idence for dopaminergic mediation of these conditions. Indeed, augment
ation of serotonin reuptake inhibitors with the atypical neuroleptic r
isperidone has been suggested to be useful in obsessive-compulsive dis
order (OCD). Method: Charts of all patients treated in our OCD clinic
with the combination of a serotonin reuptake inhibitor and risperidone
were reviewed. Demographic details of patients and clinical response
to this pharmacotherapeutic strategy were tabulated. Results: A series
of patients with OCD (N = 8), trichotillomania (N = 5), and Tourette'
s syndrome (N = 3) who were refractory to treatment with serotonin reu
ptake inhibitors had received risperidone augmentation. In a number of
cases, this strategy proved clinically effective. However, a minority
of patients experienced significant adverse effects. Conclusion: Pati
ents with OCD and related disorders are not infrequently refractory to
treatment with serotonin reuptake inhibitors. Controlled trials of ri
speridone augmentation in such patients seem warranted. In particular,
it is necessary to determine an appropriate dose range to minimize ad
verse effects.