[Obsessive-compulsive symptoms treatment in: schizophrenia]

Area of Science:

• Psychiatry
• Clinical Psychology

Background:

• Obsessive-compulsive symptoms (OCSs) are common in schizophrenia and associated with poorer outcomes.
• Atypical antipsychotic medications, including risperidone, olanzapine, and clozapine, have been anecdotally linked to the onset or exacerbation of OCSs.

Purpose of the Study:

• To review the relationship between atypical antipsychotics and OCSs in schizophrenia.
• To discuss management strategies for OCSs in this patient population.

Main Methods:

• Review of case studies and existing literature on OCSs in schizophrenia patients treated with atypical antipsychotics.
• Analysis of findings from two controlled trials investigating antiobsessive treatments (clomipramine and fluvoxamine) in schizophrenia.

Main Results:

• Clozapine is frequently implicated in the development or worsening of OCSs.
• Reducing clozapine dosage and adding a serotonin reuptake inhibitor may be effective.
• Controlled trials indicate efficacy of clomipramine and fluvoxamine for OCSs in schizophrenia, though patient samples were small and heterogeneous.

Conclusions:

• Investigating a history of OCSs before initiating atypical antipsychotic treatment is crucial.
• Close monitoring for OCS onset during treatment is necessary.
• Combined treatment with antipsychotics and antiobsessive medications is suggested for patients with schizophrenia and OCSs.