Aripiprazole versus quetiapine in treatment-resistant obsessive-compulsive disorder: a double-blind clinical trial

Around 40-60% of the patients with obsessive-compulsive disorder (OCD) remain unimproved by serotonin reuptake inhibitors (SRIs). Goal of this study was to compare the efficiency and safety of aripiprazole versus quetiapine, in patients with OCD, who did not respond effectively to fluvoxamine.

A total of 44 female inpatients with OCD, who did not respond successfully to fluvoxamine at maximum dose (300 mg/day) and duration (12 weeks), were assigned randomly, in a double-blind trial, to receive aripiprazole (n = 22) or quetiapine (n = 22), in addition to their SRI, for 12 weeks. Treatment response was assessed by the Yale-Brown Obsessive-Compulsive Scale (YBOCS), as primary outcome measure, and Clinical Global Impressions-Severity Scale (CGI-S), as a secondary outcome measure.

A total of 27.27% of the cases in the aripiprazole group (n = 6) and 54.54% of them in the quetiapine cluster (n = 12) responded moderately to the aforesaid augmentation. The mean ± SD baseline YBOCS score of 33.27 ± 3.90 dropped to a mean of 30.72 ± 4.67 (p = 0.06) in the aripiprazole group, and from 31.18 ± 4.93 to 27.97 ± 3.71 (p = 0.01) in the quetiapine group, at the end of the evaluation. There was no significant change with respect to CGI-S in either of the aforesaid groups.

This study shows that treatment-resistant OCD patients may benefit more from addition of quetiapine in comparison with aripiprazole, to their ongoing SRI therapy.