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Do antipsychotics ameliorate or exacerbate Obsessive Compulsive Disorder symptoms? A systematic review
Jitender Sareen1, Alla Kirshner, Mark Lander
1Department of Psychiatry, Obsessive Compulsive Disorder Clinic, University of Manitoba, PZ-203 771 Bannatyne Avenue, Winnipeg, MB, R3E 3N4, Canada. sareen@cc.umanitoba.ca
Journal of Affective Disorders
|October 19, 2004
Summary
Antipsychotics show short-term efficacy in augmenting treatment for refractory Obsessive Compulsive Disorder (OCD). Management for antipsychotic-induced OCD symptoms includes dose adjustment or adding SSRIs.
Area of Science:
- Psychiatry
- Pharmacology
Background:
- Conflicting reports exist on antipsychotic use in Obsessive Compulsive Disorder (OCD) treatment.
- Some studies suggest efficacy, while others indicate symptom exacerbation.
Purpose of the Study:
- To systematically review the relationship between antipsychotic drugs and OCD symptoms.
- To evaluate the efficacy of antipsychotics as augmentation therapy for refractory OCD.
Main Methods:
- A systematic literature search of Medline and PsychInfo databases (1980-2003) was performed.
- Included case series, open-label trials, and placebo-controlled trials.
Main Results:
- Antipsychotic augmentation demonstrated short-term efficacy in refractory OCD, with response rates of 46-71% in controlled trials.
- Haloperidol, risperidone, olanzapine, and quetiapine showed higher response rates compared to placebo.
- Exacerbation of OCD symptoms by atypical antipsychotics was primarily observed in patients with primary psychotic disorders.
Conclusions:
- Antipsychotics have short-term evidence supporting their use as augmenting agents for refractory OCD.
- Long-term efficacy and systematic evaluation of OCD induction by atypical antipsychotics require further study.
- Management for antipsychotic-induced OCD may involve dose increases or adding SSRIs.