Antiserotonergic antipsychotics are associated with obsessive–compulsive symptoms in schizophrenia

Abstract

OCS in schizophrenia are associated with antiserotonergic SGA treatment, but longitudinal studies have to prove causality. Before starting treatment with antiserotonergic SGAs, specific neurocognitive domains should be evaluated, as visuospatial learning and impulse inhibition performance might allow early detection of OCS secondary to antipsychotic treatment in schizophrenia.

Relationship of obsessive compulsive symptoms/disorder with clozapine: A retrospective study from a multispeciality tertiary care centre

“…The sample sizes of these studies have varied from 41 to 200 and these studies suggest that 0-28.4% of patients have new symptoms of OCS/OCD while receiving clozapine (Ertugrul et al, 2005;de Haan et al, 1999de Haan et al, , 2004Ghaemi et al, 1995;Baker et al, 1992;Mahendran et al, 2007;Lin et al, 2006;Mukhopadhaya et al, 2009;Sa et al, 2009;Bleakley et al, 2011;Doyle et al, 2014). Some studies suggest that presence of OCS/OCD may be related to the severity of primary illness, higher doses of clozapine administered and the longer duration of clozapine use (Lin et al, 2006;Schirmbeck et al, 2011;Schirmbeck and Zink, 2013); however, others have reported no such association (Ertugrul et al, 2005;Kim et al, 2012). Some studies suggest that development of OCS/OCD may be related to plasma concentration of clozapine (Lin et al, 2006) and motoric impairment (Mukhopadhaya et al, 2009).…”

“…Studies have also reported worsening of OCS/OCD in a small proportion (1.4-20.6%) of patients receiving clozapine (Ghaemi et al, 1995;de Haan et al, 1999;Baker et al, 1992;Lin et al, 2006). Some of the studies have not given breakup of de novo OCS/OCD with clozapine and preexisting OCS/OCD, but have reported these features in 76.9% of their sample (Schirmbeck et al, 2011). Occasional reports also suggest improvement in OCS with clozapine in a subgroup of patients (Reznik et al, 2004).…”

A 44-Year-Old Woman with Intrusive Thoughts

“…3,6 Use of antiserotonergic atypical antipsychotics has been implicated in association with OCS theoretically related to antagonism of the 5HT2 receptors. 7 Clozapine specifically has been cited in association with OCS in a number of case reports. 8 However, retrospective chart reviews attempting to elucidate a relationship between clozapine and OCS have been mixed.…”

The rationale for antidepressants in the treatment of schizophrenia: A modern view on the problem in the context of evidence-based medicine

“…8 Понятно, что в большинстве таких случаев антидепрессанты при-меняются в комбинации с нейролептиками. В связи с этим пред-ставляет интерес распространяющееся за рубежом мнение о спо-собности атипичных антипсихотических средств, обладающих се-ротонинергической активностью, провоцировать развитие обсес-сивно-фобической симптоматики у больных шизофренией [53,54]. Эта точка зрения делает спорным широко распространенное мнение, в соответствии с которым атипичные нейролептики рас-сматриваются как средство выбора при лечении обсессивно-фоби-ческих расстройств у больных шизофренией.…”