Clozapine-Induced Obsessive-Compulsive Symptoms and Augmentation with Clonazepam: Risks and Rationales

Obsessive-compulsive symptoms induced by clozapine negatively affect treatment compliance. In some studies, clonazepam was shown to be beneficial in obsessive-compulsive disorder. However, in literature there are case reports of life-threatening complications associated with the combined use of clozapine and benzodiazepines. In this article, the efficacy and safety of the clonazepam augmentation were discussed in two patients who had obsessive-compulsive symptoms induced by clozapine. No life-threatening complications were detected during the follow-up period of more than two years, and the patients benefited dramatically from the addition of clonazepam. In treatment-resistant patients, clonazepam can be used with close monitoring for obsessivecompulsive symptoms associated with atypical antipsychotics. Keywords: Atypical antipsychotics, clonazepam, clozapine, obsessivecompulsive symptoms.