Olanzapine augmentation for treatment-resistant obsessive-compulsive disorder

Area of Science:

• Psychiatry
• Pharmacology
• Neuroscience

Background:

• Treatment-refractory obsessive-compulsive disorder (OCD) can be challenging to manage.
• Risperidone augmentation of serotonin reuptake inhibitors (SRIs) has shown efficacy in some OCD patients.
• Olanzapine shares receptor binding profiles with risperidone, suggesting potential therapeutic overlap.

Purpose of the Study:

• To investigate the efficacy of olanzapine augmentation in patients with treatment-unresponsive OCD.
• To test the hypothesis that olanzapine, similar to risperidone, could benefit refractory OCD cases.

Main Methods:

• An 8-week open-label trial involving 10 adult OCD patients unresponsive to fluoxetine.
• Olanzapine was initiated at 2.5 mg/day and titrated up to 10 mg/day based on response and tolerability.
• Concurrent psychotropic medications were discontinued, with fluoxetine maintained.

Main Results:

• Nine patients completed the trial, with a mean Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score reduction of 16%.
• Three patients (33%) responded to olanzapine augmentation, with one achieving "much improved" status.
• Significant weight gain was observed in 60% of participants; mood symptom improvement was not correlated with OCD improvement.

Conclusions:

• Olanzapine augmentation shows potential as an adjunctive treatment for treatment-unresponsive OCD.
• Further investigation through double-blind, placebo-controlled trials is recommended.
• Comparative studies of olanzapine versus risperidone augmentation in OCD are warranted.