Suicidality in clozapine-treated patients with schizophrenia: Role of obsessive-compulsive symptoms

Szmulewicz, Alejandro G.; Smith, José; Valerio, Marina P

doi:10.1016/j.psychres.2015.07.089

Cited by 23 publications

(9 citation statements)

References 51 publications

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“…Atypical APs have a preferential occupancy of 5HT2 receptors over D2 (Kapur et al 1998 , 1999 , 2006 ) being this profile of antiserotoninergic properties thought to be the cause of OCS induction (Schirmbeck et al 2011 ; 2013 ; Schirmbeck and Zink 2012 2013 ). Recent studies suggest that OCD and OCS are associated with greater suicidal risk in patients with schizophrenia (Niendam et al 2009 ; DeVylder et al 2012 ; Hagen et al 2013 ; Szmulewicz et al 2015a ), underlining the importance of this BAE.…”

Section: Resultsmentioning

confidence: 99%

Behavioral and emotional adverse events of drugs frequently used in the treatment of bipolar disorders: clinical and theoretical implications

Szmulewicz

Samamé

Caravotta

et al. 2016

Int J Bipolar Disord

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BackgroundBehavioral and emotional adverse events induced by drugs commonly prescribed to patients with bipolar disorders are of paramount importance to clinical practice and research. However, no reviews on the topic have been published so far.MethodsAn extensive search was performed. Reports were reviewed if they described behavioral side effects related to pharmacological treatments for bipolar disorders in healthy subjects or patients with different neuropsychiatric disorders. For this review, lithium, antipsychotics, anticonvulsants and selective serotonin reuptake inhibitors were included.ResultsApathy or emotional blunting, diminished sexual desire, and inability to cry were reported to be associated with exposure to selective serotonin reuptake inhibitors. Neuroleptic-induced deficit syndrome/emotional detachment and obsessive–compulsive symptomatology and decision-making modifications. A lithium-related amotivational syndrome was also reported in the literature. Furthermore, hypersexuality and obsessive–compulsive symptoms have been noted in subjects treated with lamotrigine.LimitationsPrimary studies on drug-related adverse events are scant so far and most of the data currently available derive from case reports. Moreover, most of the evidence reviewed is based on studies performed on healthy subjects and patients with neuropsychiatric conditions other than bipolar disorders.DiscussionThere is a remarkable dearth of data on behavioral adverse events of pharmacological treatment for bipolar disorders. However, the pieces of evidence available at present, though scant and scattered, suggest that different behavioral adverse events may be related to pharmacological treatment for these disorders. The implications of these findings for research and management of patients with mood disorders are discussed.

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Section: Resultsmentioning

confidence: 99%

Behavioral and emotional adverse events of drugs frequently used in the treatment of bipolar disorders: clinical and theoretical implications

Szmulewicz

Samamé

Caravotta

et al. 2016

Int J Bipolar Disord

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“…Moreover, the comorbidity is associated with more severe positive, negative and affective symptoms (Cunill, Castells, & Simeon, 2009;F. Schirmbeck, Konijn, Hoetjes, Zink, & de Haan, 2018), increased suicidality (Sevincok, Akoglu, & Kokcu, 2007;Szmulewicz, Smith, & Valerio, 2015), more social dysfunction (de Haan, Sterk, & van der Valk, 2013;Hunter & Lysaker), a lower socioeconomic status, and significantly earlier onset of schizophrenia compared with patients without comorbid OCS (Owashi, Ota, Otsubo, Susa, & Kamijima, 2010).…”

Section: Introductionmentioning

confidence: 99%

Childhood trauma and coping in patients with psychotic disorders and obsessive-compulsive symptoms and in un-affected siblings

Renkema

Haan

Schirmbeck

et al. 2020

Child Abuse & Neglect

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Background: Research on environmental and individual riskfactors in patients with a psychotic disorder and co-occurring obsessivecompulsive symptoms (OCS) is limited. Objective: This study aimed to examine the role of childhood trauma and coping on the occurrence of OCS in patients with a psychotic disorder and on a subclinical level in siblings. Participants and setting: 626 patients and 638 siblings from the Genetic Risk and Outcome of Psychosis (GROUP) study were included in the current study. Methods: Differences between patients and siblings with and without OCS were analyzed with between-group comparisons. Mediation analyses investigated the effect of coping on the association between trauma and OCS severity. Results: Patients and siblings with OCS reported more childhood traumatic events, particularly sexual (OR=1.62 / 3.26) and emotional (OR=1.47 / 2.04) abuse compared to those without OCS. Both patients (d=0.69) and siblings (d=0.49) with co-occurring OCS showed a higher tendency for dysfunctional passive coping strategies compared to the group without OCS. The tendency for passive coping mediated the association between sexual and emotional abuse and OCS severity in patients. Conclusions: Results imply that childhood trauma is associated with the presence of co-occurring OCS. Enhancing active coping strategies might have a beneficial effect in the prevention and treatment of co-occurring OCS in patients with psychotic disorders.Dear Editor, attached you will find the revised version of our article with the title ´Childhood trauma and coping in patients with psychotic disorders and obsessive-compulsive symptoms and in un-affected siblings´.We are really grateful for the opportunity to have our work considered for publication in Child Abuse & Neglect. We have responded to the requested revisions. Changes made in the text have been highlighted in yellow.

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“…In two of the cases the antipsychotic involved was clozapine, which is most associated with the development of OCS. 1 In all cases there was a significant latency period of greater than six months between starting the antipsychotic and the development of OCS. Previous reports have noted that OCS can occur as early as one month after starting clozapine and as late as five years.…”

Section: Discussionmentioning

confidence: 92%

“…However, they can be disabling and, if left untreated, cause significant negative outcomes for the patient. 1 The prevalence of the presentation has been estimated in the range of 7-64%. [2][3][4] It is postulated that comorbid OCS and schizophrenia has a worse prognosis.…”

mentioning

confidence: 99%

Obsessive‐compulsive symptoms: a side‐effect of antipsychotic treatment

Ukaegbu¹,

Dunne²,

Getachew³

2016

Prog Neurol Psychiatry

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Obsessive‐compulsive symptoms (OCS) secondary to antiserotonergic antipsychotic treatment of schizophrenia appear to have a significant prevalence from previous studies but can be very difficult to detect as they are overshadowed by the diagnosis of schizophrenia. Here, the authors describe three cases where patients have developed OCS after starting risperidone in one case, and clozapine in two other cases and how significant improvements can be achieved with SSRIs and, if necessary, cognitive behavioural therapy (CBT).

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Suicidality in clozapine-treated patients with schizophrenia: Role of obsessive-compulsive symptoms

Cited by 23 publications

References 51 publications

Behavioral and emotional adverse events of drugs frequently used in the treatment of bipolar disorders: clinical and theoretical implications

Behavioral and emotional adverse events of drugs frequently used in the treatment of bipolar disorders: clinical and theoretical implications

Childhood trauma and coping in patients with psychotic disorders and obsessive-compulsive symptoms and in un-affected siblings

Obsessive‐compulsive symptoms: a side‐effect of antipsychotic treatment

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