The improvement of obsessive– compulsive symptoms in a patient with schizophrenia treated with clozapine

Kumar, Shailesh; Ng, Bradley; Howie, William

doi:10.1046/j.1440-1819.2003.01107.x

Cited by 10 publications

(8 citation statements)

References 4 publications

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“…In the present study, interestingly, the age at onset for OC symptoms was significantly lower than the age at onset for other symptoms because (i) some schizophrenia patients often suffer from OC symptoms, (ii) schizophrenia patients with OC symptoms have more severe clinical symptoms, and (iii) OC symptoms are induced by atypical antipsychotic medications 18,28–35 . Unfortunately, with regard to the frequency of OC symptoms, we could not compare the present results with those of previous similar studies given in Table 4 because there was no description of this in those studies.…”

Section: Discussioncontrasting

confidence: 70%

“…Second, it is possible that the lack of a special instrument for the assessment of potentially prodromal symptoms or onset of illness, such as the Instrument for the Retrospective Assessment of Schizophrenia (IRAOS) had an influence on our results. Third, as for help‐seeking behavior, the majority of patients with first‐episode psychosis may not seek professional help prior to the first psychotic episode despite experiencing mental problems/symptoms at pre‐onset 24,28 . To confirm the present findings therefore additional prospective studies in Japanese subjects with the aforementioned instrument are needed.…”

Section: Discussionmentioning

confidence: 65%

“…3,24 In the present study, interestingly, the age at onset for OC symptoms was significantly lower than the age at onset for other symptoms because (i) some schizophrenia patients often suffer from OC symptoms, (ii) schizophrenia patients with OC symptoms have more severe clinical symptoms, and (iii) OC symptoms are induced by atypical antipsychotic medications. 18,[28][29][30][31][32][33][34][35] Unfortunately, with regard to the frequency of OC symptoms, we could not compare the present results Early prodromal symptoms in schizophrenia with those of previous similar studies given in Table 4 because there was no description of this in those studies. Iida et al, who examined the clinical features of childhood-onset schizophrenia with OC symptoms during prodromal phase, noted that the group with OC symptoms was characterized by a higher ratio of male patients, higher incidences of perinatal factors, fewer hereditary factors, longer duration of the prodromal phase, and a higher incidence of insidious onset and negative symptoms compared with the groups without such prodromal symptoms and suggested the possibility of subtype categorization.…”

Section: Discussionmentioning

confidence: 77%

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Early prodromal symptoms and diagnoses before first psychotic episode in 219 inpatients with schizophrenia

Shioiri

Shinada

Kuwabara

et al. 2007

Psychiatry Clin Neurosci

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The authors examined the diagnosis before the onset of schizophrenia and retrospectively evaluated the presence/absence of early prodromal symptoms (EPS) and their types (such as depressive symptoms, anxiety symptoms, and obsessive-compulsive [OC] symptoms) and the period from the onset of these symptoms to that of schizophrenia in 219 inpatients with schizophrenia diagnosed according to the DSM-IV(-TR). A diagnosis was made before the onset of schizophrenia in 53 patients (24.2%). The diagnoses were mood disorder in 39 patients, anxiety disorder in seven, obsessive-compulsive disorder (OCD) in three, adjustment disorder in two, and eating disorder in two. EPS were present in 65 (29.7%) of all patients, slightly more frequent in female patients (male : female = 1:1.41). In the group with EPS, depressive symptoms (61.5%) were most frequently observed, followed by anxiety symptoms (23.1%) and OC symptoms (9.2%). The age at onset for each type of symptom was significantly lower for OC symptoms (14.5 Ϯ 2.4 years) than for the other symptoms (approx. 20 years). The mean period from the onset of each symptom to that of schizophrenia was the shortest for depressive symptoms (2.7 Ϯ 3.1 years) and the longest (>4 years) for OC symptoms. These results as well as previous studies in Western countries showed that more non-specific and general symptoms are frequently present for some years before the onset of schizophrenia. With consideration of this point, efforts toward early detection of schizophrenia are important.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 77%

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Early prodromal symptoms and diagnoses before first psychotic episode in 219 inpatients with schizophrenia

Shioiri

Shinada

Kuwabara

et al. 2007

Psychiatry Clin Neurosci

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“…15 Average clozapine dose is under 300 mg/d when treating OCS, whereas patients with worsening OCS were often prescribed larger doses. 16 This case also demonstrated that low-dose clozapine was effective in treating OCS.…”

Section: Discussionmentioning

confidence: 60%

Clozapine for Blepharospasm, Obsessive-Compulsive Symptoms, and Psychotic Symptoms in a Patient of Old Brain Infarction

Sun¹,

Lu²,

Huang³

2006

Clinical Neuropharmacology

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Blepharospasm, psychotic symptoms, and obsessive-compulsive symptoms can result from brain infarction. However, a presentation of these 3 symptoms simultaneously is rare. This report describes a 65-year-old woman who had old brain infarction and presented with these 3 symptoms for 2 years. The patient recovered after receiving a regimen of clozapine 125 mg/d for 3 months. No recurrences of symptoms were noted during a 6-month follow-up. This is the first case report demonstrating that clozapine is effective for a patient with blepharospasm, obsessive-compulsive symptoms, and psychotic symptoms presenting simultaneously. This report also reminds physicians of the possible organic causes of unusual presentations in elderly patients.

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“…Andere Autoren empfehlen jedoch dem widersprechend hohe Dosen von Atypika[141], um sowohl antipsychotische als auch antiobsessive Wir− kungen erreichen zu können. Insgesamt mehren sich die Hinwei− se, dass eine neuroleptische Medikation schwere Zwangssymp− tome bei zugrunde liegender Schizophrenie mildern kann[50,53,56,57]. Die kontroverse Diskussion ist am Beispiel des Risperidons bei Veznedaroglu u. Mitarb.…”

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Zwang und Schizophrenie

Frommhold¹

2006

Fortschr Neurol Psychiatr

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Co-occurrence of psychotic and obsessive-compulsive symptoms has been recognized for decades. This paper reviews published reports from five perspectives: schizophrenia with obsessive-compulsive symptoms, obsessive-compulsive disorder (OCD) with psychotic symptoms, schizophrenia-spectrum-personality disorder with obsessive-compulsive symptoms, obsessive-compulsive symptoms induced by atypical antipsychotics and similarities of functional neural circuits theory in OCD and schizophrenia. A MEDLINE search was conducted to identify relevant articles from 1960 until 2004. Only a few systematic data that explore the nature and significance of such occurrence have been published. More recent studies using systematic diagnostic criteria suggest that the rate of occurrence may not be rare at all. In schizophrenia, a similar dorsolateral prefrontal cortex circuit shares anatomic substrates similar to those of the OCD orbitofrontal circuit. Exploring the interface of schizophrenic and obsessive-compulsive symptoms is important for diagnostic clarity and could have important implications for treatment and long-term prognosis. The review emphasizes the different origins and natural course of co-occurrence of schizophrenic and obsessive-compulsive symptoms and their various outcome under atypical antipsychotics and selective serotonin reuptake inhibitors (SSRI). Further double-blind, randomized, placebo-controlled investigations in larger cohorts of schizophrenic and OCD patients are needed in order to identify a schizo-obsessive schizophrenia and a schizotypal subtype of obsessive compulsive disorder and to substantiate the algorithm for treatment.

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The improvement of obsessive– compulsive symptoms in a patient with schizophrenia treated with clozapine

Cited by 10 publications

References 4 publications

Early prodromal symptoms and diagnoses before first psychotic episode in 219 inpatients with schizophrenia

Early prodromal symptoms and diagnoses before first psychotic episode in 219 inpatients with schizophrenia

Clozapine for Blepharospasm, Obsessive-Compulsive Symptoms, and Psychotic Symptoms in a Patient of Old Brain Infarction

Zwang und Schizophrenie

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