Risperidone augmentation in the treatment of severe adolescent OCD in SSRI-refractory cases: a case-series

The adverse effects and potential clinical value of risperidone as augmentation to selective serotonin reuptake inhibitor (SSRI) treatment in treatment resistant severe adolescent OCD patients were examined in 17 adolescents (15-19 years old, 8 males and 9 females) in an open label trial of risperidone 1-2 mg daily.

After 12 weeks of augmenting treatment, statistically significant improvements were reflected in OCD symptom ratings (mean total Y-BOCS/CY-BOCS scores after treatment with second SSRI 24.2 +/- 2.6 versus 19.9 +/- 2.9, p < 0.001) and global assessment scores (mean CGAS, 69.4 +/- 11.4 versus 74.7 +/- 9.6, p < 0.001). Four patients had moderate improvement of more than 25% reduction in Y-BOCS scores in OCD symptoms. Further 10 patients had a reduction of 10-25% in total score, indicating slight improvement. One patient (6%) dropped from clinical OCD to a subclinical level of OCD (Y-BOCS total score < 15). No patient was found to have worsened during augmentation treatment. Eight cases had weight gain and sedation was reported in four cases.

These preliminary findings suggest that augmentation with risperidone in dosages up to 2 mg daily might be efficient in adolescents with treatment resistant OCD.