An open study of fluvoxamine augmentation of neuroleptics in schizophrenia with obsessive and compulsive symptoms

Patients whose schizophrenia is characterized by marked obsessive-compulsive features can be difficult to treat successfully and often require a combination treatment. The aim of this open-label study was to evaluate the efficacy and tolerability of an addition of fluvoxamine--a selective serotonin reuptake inhibitor (SSRI)--to standard neuroleptics in treatment of obsessive-compulsive (OC) symptomatology in patients with schizophrenia. Sixteen patients with schizophrenia were treated with conventional neuroleptics and fluvoxamine in doses of 100-200 mg/d for 8 weeks. The patients were assessed with use of the Brief Psychiatric Rating Scale (BPRS) and the Yale Brown Obsessive-Compulsive Scale (YBOCS) at baseline and endpoint. Results included considerable reduction in BPRS (39.4%) and Y-BOCS (32.9%) scores. None of the patients showed an acute exacerbation during the whole study period. Side effects were clinically insignificant. This open-label trial supports previous suggestions that coadministration of SSRIs and neuroleptics in patients with schizophrenia with OC symptoms is associated with robust improvements of these symptoms. Therefore, the use of SSRIs in patients with schizophrenia with OC symptomatology may be warranted and safe.