Aripiprazole as an augmentation agent in treatment-resistant body dysmorphic disorder

Body dysmorphic disorder (BDD) is a relatively common and severe disorder for which pharmacotherapy has been only minimally studied. BDD often appears to respond to selective serotonin reuptake inhibitors (SSRIs), but many patients do not respond or respond only partially. Investigation of SSRI augmentation strategies is therefore needed. We report a case of treatment-resistant BDD that was successfully treated with pharmacological augmentation of fluvoxamine with aripiprazole. The patient, a 43-year-old woman, had been taking a stable dose of fluvoxamine (400 mg/day) for 6 months when she was started on aripiprazole (10 mg/day). After 10 weeks of this treatment, her clinical condition improved markedly, as indicated by a significant decrease in the Body Dysmorphic Disorder Examination score. This case presents some preliminary evidence that addition of the atypical antipsychotic agent aripiprazole may be useful in patients with treatment-resistant BDD. However, results from controlled studies are needed to support this finding.