July 13, 2005

Antipsychotics Suppress OCD Symptoms

NEW YORK (Reuters Health) -- People suffering with obsessive-compulsive disorder (OCD) who do not respond adequately to antidepressant therapy may benefit from the addition of an antipsychotic agent, results of a study hint.

While antidepressants are commonly used to treat OCD, approximately half of patients do not respond to these drugs when used alone, study investigators explain in a report in the Journal of Clinical Psychiatry

Dr. Xiaohua Li, from the University of Alabama at Birmingham, and associates tested whether adding an antipsychotic might help these non-responders.

They had 12 patients with severe OCD on "stable-dose" antidepressant therapy add risperidone (1 milligram daily), haloperidol (2 milligrams daily) or placebo for 2 weeks each in a crossover fashion, with a 2-week placebo washout period between treatments.

Li and colleagues report that both antipsychotics led to a rapid and significant reduction in OCD behavior compared with placebo.

Considering that the patients had severe lingering OCD symptoms during antidepressant treatment only, "a significant reduction in obsession within 2 weeks of treatment initiation with each drug is notable," the authors comment.

Both drugs also significantly reduced anxiety among the patients and risperidone, but not haloperidol, also improved depressed mood and enhanced overall well-being, the authors report.

Five subjects discontinued haloperidol before the 2-week phase was complete due to side effects such as lethargy (sluggishness) or dystonia (prolonged, repetitive muscle contractions), whereas all of the participants completed the risperidone phase.

This study, say the authors, suggests that adding an antipsychotic to an antidepressant may be of benefit in OCD patients who do not respond to antidepressant therapy alone.

SOURCE: Journal of Clinical Psychiatry June 2005.