A case series of aripiprazole augmentation of selective serotonin reuptake inhibitors in treatment-refractory obsessive compulsive disorder

Abstract

Objective. For the obsessive compulsive disorder (OCD) patients refractory to selective serotonin reuptake inhibitors (SSRIs), atypical antipsychotics, such as risperidone, or olanzapine have been found effective in the augmentation of SSRIs. However these atypical antipsychotics may cause a number of safety concerns associated with body weight or metabolic changes. We sought to investigate the efficacy and safety of a novel atypical neuroleptic aripiprazole as an augmenting agent for the treatment-resistant OCD. Methods. Eleven patients who had previously been assessed as poorer responders (<10% reduction of Y-BOCS) to both adequate SSRI monotherapy such as fluvoxamine or paroxetine and the subsequent atypical antipsychotic augmentation of SSRIs were included in this study. The addition of aripiprazole to ongoing SSRIs was continued for at least 12 weeks in the subjects except for one who dropped out during the period. Results. The mean maximum daily dosage of aripiprazole in the completers was 10.9 ± 3.4 mg/day. Seven of 10 completers exhibited significant reduction of Y-BOCS (>35%) accompanying a few adverse events. Conclusions. This preliminary study supports the notion that adding aripiprazole to SSRIs could be a valid and effective strategy for treatment-resistant OCD patients. Thus it points towards the need of further controlled and longitudinal studies.

Key Words::

• Obsessive-compulsive disorder
• aripiprazole
• atypical antipsychotic drug
• augmentation
• treatment-refractory

Acknowledgements

This study was supported in part by a grant-in-aid for scientific research from the Japanese Ministry of Education, Culture, Sports, Science, and Technology (No. 18591305).

Statement of Interest

None to declare.