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Management of obsessive-compulsive disorder comorbid with bipolar disorder
1Department of Psychiatry, Government Medical College, Kozhikode, Kerala, India.
Indian Journal of Psychiatry
|January 10, 2017
Summary
Treating obsessive-compulsive disorder (OCD) alongside bipolar disorder (BD) is challenging. Limited evidence suggests adjuvant topiramate or olanzapine with mood stabilizers may help manage this common comorbidity.
Area of Science:
- Psychiatry
- Neuroscience
- Pharmacology
Background:
- Obsessive-compulsive disorder (OCD) frequently co-occurs with bipolar disorder (BD), complicating treatment decisions.
- Pharmacotherapy for OCD can worsen mood instability in BD, while psychotherapy may be impractical during acute BD episodes.
Approach:
- This study reviewed existing literature on treating comorbid OCD and BD.
- The review assessed the efficacy of current BD guideline-based treatments for OCD and explored newer agents.
Key Points:
- Treatment for comorbid OCD in BD is significantly understudied.
- Adjuvant topiramate or olanzapine combined with selective serotonin reuptake inhibitors/clomipramine and a mood stabilizer showed effectiveness for OCD in BD.
- Evidence for other pharmacological agents and psychotherapy is limited, primarily based on case reports.
Conclusions:
- Existing treatments for bipolar disorder may not be directly applicable or effective for comorbid OCD.
- Further research is crucial to establish effective treatment strategies for this prevalent comorbidity.
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