TREATMENT OF OBSESSIVE-COMPULSIVE SYMPTOMS IN SCHIZOPHRENIC-PATIENTS WITH CLOMIPRAMINE

Recent studies show that obsessive-compulsive symptoms may occur in ma ny patients with schizophrenia and may predict a poor prognosis. Pilot studies have shown that some schizophrenic patients may improve if a serotonin reuptake blocker is added to their neuroleptic. We have perf ormed a pilot, double-blind, crossover study of clomipramine (CMI) or placebo, added to maintenance psychotropic medication. Six schizophren ic patients with obsessive-compulsive symptoms were studied in a doubl e-blind CMI versus placebo crossover protocol. The patients met DSM-II I-R criteria for chronic schizophrenia, experienced obsessive-compulsi ve symptoms, and had been previously stabilized on their psychiatric m edication. The patients were rated at baseline and longitudinally thro ugh the study with the Positive and Negative Symptom Scale for Schizop hrenia (PANSS) and the Yale Brown Obsessive-Compulsive Scale (YBOCS). An analysis of covariance was used to compare the drug versus placebo effect at the final visit with the baseline rating as a covariate. Rat ings on both the YBOCS and the PANSS showed that patients improved sig nificantly more on CMI than on placebo. No patients experienced an exa cerbation of psychotic symptoms. Preliminary findings from this double -blind, crossover, pilot study of CMI and placebo, designed to assess the effect of CMI in the treatment of schizophrenic patients with obse ssive symptoms, suggest that CMI is superior to placebo in the treatme nt of obsessions and compulsions and improves overall schizophrenic sy mptoms. Further studies with larger samples and longer follow-up perio d are necessary to confirm these preliminary findings.