Risperidone augmentation in treatment-resistant obsessive-compulsive disorder: a double-blind, placebo-controlled...

Area of Science:

• Psychiatry
• Pharmacology
• Clinical Medicine

Background:

• Treatment-resistant obsessive-compulsive disorder (OCD) poses a significant clinical challenge.
• Serotonin reuptake inhibitors (SRIs) are first-line treatments, but many patients do not achieve adequate response.
• Augmentation strategies are needed for patients with refractory OCD.

Purpose of the Study:

• To evaluate the efficacy and tolerability of risperidone augmentation in adult patients with treatment-resistant OCD.
• To compare risperidone augmentation versus placebo in SRI-treated patients.
• To identify predictors of response to risperidone augmentation.

Main Methods:

• A double-blind, placebo-controlled trial involving 16 adult treatment-resistant OCD patients.
• Patients received either risperidone (0.5-3.0 mg/d) or placebo for 8 weeks, added to ongoing SRI treatment.
• Efficacy was assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Clinical Global Impression - Improvement (CGI-I) scale.

Main Results:

• 40% of patients receiving risperidone augmentation responded (CGI-I score 1-2 and Y-BOCS decrease ≥25%), compared to 0% in the placebo group.
• Risperidone augmentation was generally well-tolerated, with similar dropout rates between groups.
• Baseline Y-BOCS insight score correlated with greater improvement in CGI-I score with risperidone.

Conclusions:

• Risperidone may be an effective and well-tolerated augmentation strategy for treatment-resistant OCD.
• Larger studies are needed to confirm these findings and establish risperidone's role in OCD treatment.
• Understanding baseline patient characteristics, like insight, may help predict treatment response.