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Current Psychopharmacology

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ISSN (Print): 2211-5560
ISSN (Online): 2211-5579

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Research Article

Evaluation of Second Generation Antipsychotics, as Augmentative Plan, in Treatment-Resistant Obsessive-Compulsive Disorder

Author(s): Saeed S. Shafti* and Hamid Kaviani

Volume 8, Issue 2, 2019

Page: [146 - 154] Pages: 9

DOI: 10.2174/2211556008666190314113446

Abstract

Introduction: Since around half of the patients with obsessive-compulsive disorder do not respond efficiently to current serotonin- reuptake inhibitors, the objective of the present study was to compare the effectiveness and safety of quetiapine against aripiprazole in patients with obsessive-compulsive disorder, who had not responded successfully to fluvoxamine.

Methods: Forty-four patients with obsessive-compulsive disorder, who had not responded efficaciously to fluvoxamine, at maximum dose (300 milligrams per day) and duration (twelve weeks), were allocated randomly in a double-blind assessment to take quetiapine (n=22) or aripiprazole (n=22), plus their serotonin-reuptake inhibitor for twelve weeks. While treatment response was evaluated by the Yale- Brown Obsessive-Compulsive Scale (YBOCS), as the main outcome scale, Clinical Global Impressions-Severity Scale (CGI-S) was also used as an ancillary measure.

Results: 54.54% of patients in the quetiapine group and 27.27% of them in the aripiprazole group responded partially to the abovementioned on treatment adds. According to the findings, the YBOCS score dropped from 31.18+/-4.93 to 27.97+/-3.71 (p< 0.01), and 33.27 +/- 3.90 to 30.72+/-4.67 (p < 0.06), for quetiapine and aripiprazole, respectively. In this regard, no substantial alteration regarding CGI-S was evident in each of the aforementioned groups.

Conclusion: This assessment indicated that patients with treatment-resistant obsessivecompulsive disorder could benefit more from adding quetiapine, in comparison with aripiprazole, to their current serotonergic medication.

Keywords: Aripiprazole, obsessive-compulsive disorder, quetiapine, treatment-resistant, antipsychotics, fluvoxamine.

Graphical Abstract

[1]
Hirschtritt ME, Bloch MH, Mathews CA. Obsessive-compulsive disorder: advances in diagnosis and treatment. JAMA 2017; 317(13): 1358-67.
[2]
Torres A, Prince M, Bebbington P, et al. Obsessive-compulsive disorder: prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Comorbidity Survey of 2000. Am J Psychiatry 2006; 163: 1978-85.
[3]
Kessler R, Berglund P, Demler O, Jin R, Walters E. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 593-602.
[4]
Steketee G, Barlow D. Obsessive-compulsive disorder. In: Barlow DH, Ed. Anxiety and its disorders. 2nd ed. Guilford press: New York 2002; pp. 516-50.
[5]
Mataix-Cols D, Rauch S, Baer L, et al. Symptom stability in adult obsessive-compulsive disorder: data from a naturalistic two-year follow-up study. Am J Psychiatry 2002; 159: 263-8.
[6]
Stewart S, Geller D, Jenike M, et al. Long-term outcome of pediatric obsessive-compulsive disorder: a meta-analysis and qualitative review of the literature. Acta Psychiatr Scand 2004; 110: 4-13.
[7]
Heyman I, Fombonne E, Simmons H, Ford T, Meltzer H, Goodman R. Prevalence of obsessive-compulsive disorder in the British nationwide survey of child mental health. Int Rev Psychiatry 2003; 15: 178-84.
[8]
Fontenelle LF, Mendlowicz MV, Versiani M. The descriptive epidemiology of obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2006; 30: 327-37.
[9]
Spitzer M, Sigmund D. The phenomenology of obsessive-compulsive disorder. Int Rev Psychiatry 1997; 9: 7-14.
[10]
Alvarenga PG, Hounie AG, Mercadante MT, Miguel EC, Conceicao M. Obsessive-compulsive disorder: a historical overview. In: Storch EA, Geff ken GR, Murphy TK, Eds Handbook of child and adolescent obsessive-compulsive disorder. Erlbaum: Mahwah, NJ 2007; pp. 1-15.
[11]
Pallanti S. Transcultural observations of obsessive-compulsive disorder. Am J Psychiatry 2008; 165: 169-70.
[12]
Vishne T, Misgav S, Bunzel ME. Psychiatric disorders related to menstrual bleeding among an ultra-Orthodox population: case series and literature review. Int J Soc Psychiatry 2008; 54: 219-24.
[13]
Lopez-Ibor J, Lopez-Ibor M. Research on obsessive-compulsive disorder. Curr Opin Psychiatry 2003; 16(Suppl. 2): S85-91.
[14]
Griest JH. Jeff erson JW, Kobak KA, Katzelnick DJ, Serlin RC. Efficacy and tolerability of serotonin transport inhibitors in obsessive-compulsive disorder. A meta-analysis. Arch Gen Psychiatry 1995; 52: 53-60.
[15]
Camarena B, Loyzaga C, Aguilar A, Weissbecker K, Nicolini H. Association study between the dopamine receptor D-sub-4 gene and obsessive-compulsive disorder. Eur Neuropsychopharmacol 2007; 17: 406-9.
[16]
Rauch S, Whalen P, Dougherty D, Jenike M. Neurobiologic models of obsessive-compulsive disorder. In: Jenike MA, Baer L, Minichiello WE, Eds. Obsessive-compulsive disorders: practical management. Mosby: St Louis 1998; pp. 222-53.
[17]
Whiteside S, Port J, Abramowitz J. A meta-analysis of functional neuroimaging in obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2004; 132: 69-79.
[18]
Rocha FF, Correa H, Teixeira AL. Obsessive-compulsive disorder and immunology: a review. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32: 1139-46.
[19]
Pallanti S, Grassi G, Sarrecchia ED, Cantisani A, Pellegrini M. Obsessive-compulsive disorder comorbidity: clinical assessment and therapeutic implications. Front Psychiatry 2011; 2: 70.
[20]
Subramaniam M, Soh P, Vaingankar JA, Picco L, Chong SA. Quality of life in obsessive-compulsive disorder: impact of the disorder and of treatment. CNS Drugs 2013; 27(5): 367-83.
[21]
Veale D, Miles S, Smallcombe N, Ghezai H, Goldacre B, Hodsoll J. Atypical antipsychotic augmentation in SSRI treatment refractory obsessive-compulsive disorder: a systematic review and meta-analysis. BMC Psychiatry 2014; 29(14): 317.
[22]
Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry 2006; 11(7): 622-32.
[23]
Kordon A, Wahl K, Koch N, et al. Quetiapine addition to serotonin reuptake inhibitors in patients with severe obsessive-compulsive disorder: a double-blind, randomized, placebo-controlled study. J Clin Psychopharmacol 2008; 28(5): 550-4.
[24]
Carey PD, Vythilingum B, Seedat S, et al. Quetiapine augmentation of SRIs in treatment refractory obsessive-compulsive disorder: a double-blind, randomized, placebo-controlled study. BMC Psychiatry 2005; 24(5): 5.
[25]
Denys D, de Geus F, van Megen HJ, et al. A double-blind, randomized, placebo-controlled trial of quetiapine addition in patients with obsessive-compulsive disorder refractory to serotonin reuptake inhibitors. J Clin Psychiatry 2004; 65(8): 1040-8.
[26]
Fineberg NA, Stein DJ, Premkumar P, et al. Adjunctive quetiapine for serotonin reuptake inhibitor-resistant obsessive-compulsive disorder: a meta-analysis of randomized controlled treatment trials. Int Clin Psychopharmacol 2006; 21(6): 337-43.
[27]
Pessina E, Albert U, Bogetto F, Maina G. Aripiprazole augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder: a 12-week open-label preliminary study. Int Clin Psychopharmacol 2009; 24(5): 265-9.
[28]
Muscatello MR, Bruno A, Pandolfo G, et al. Effect of aripiprazole augmentation of serotonin reuptake inhibitors or clomipramine in treatment-resistant obsessive-compulsive disorder: a double-blind, placebo-controlled study. J Clin Psychopharmacol 2011; 31(2): 174-9.
[29]
Delle Chiaie R, Scarciglia P, Pasquini M, et al. Aripiprazole augmentation in patients with resistant obsessive compulsive disorder: a pilot study. Clin Pract Epidemiol Ment Health 2011; 7: 107-11.
[30]
Ak M, Bulut SD, Bozkurt A, Ozsahin A. Aripiprazole augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder: a 10-week open-label study. Adv Ther 2011; 28(4): 341-8.
[31]
American psychiatric association Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text rev.. Washington, DC: American Psychiatric Association 2000.
[32]
Goodman WK, Price LH, Rasmussen SA, et al. The yale-brown obsessive compulsive scale, 1: development, use, and reliability. Arch Gen Psychiatry 1998; 46: 1006-11.
[33]
Guy W. ECDEU Assessment manual for psychopharmacology. DHEW Publication: Rockville 1976.
[34]
Fenske JN, Schwenk TL. Obsessive-compulsive disorder: diagnosis and management. Am Fam Physician 2009; 80(3): 239-45.
[35]
Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62(6): 617-27.
[36]
Koran LM. Quality of life in obsessive-compulsive disorder. Psychiatr Clin North Am 2000; 23(3): 509-17.
[37]
Pinto A, Mancebo MC, Eisen JL, Pagano ME, Rasmussen SA. The brown longitudinal obsessive compulsive study: clinical features and symptoms of the sample at intake. J Clin Psychiatry 2006; 67(5): 703-11.
[38]
Canadian Psychiatric Association. Clinical practice guidelines. Management of anxiety disorders. Can J Psychiatry 2006; 51(8)(Suppl. 2): 9S-91S.
[39]
Kamath P, Reddy YC, Kandavel T. Suicidal behavior in obsessive-compulsive disorder. J Clin Psychiatry 2007; 68(11): 1741-50.
[40]
Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry 2006; 11(7): 622-32.
[41]
Selvi Y, Atli A, Aydin A, Besiroglu L, Ozdemir P, Ozdemir O. The comparison of aripiprazole and risperidone augmentation in selective serotonin reuptake inhibitor-refractory obsessive-compulsive disorder: a single-blind, randomised study. Hum Psychopharmacol 2011; 26(1): 51-7.
[42]
Weiss El. Potenza MN, McDougle CJ, at el. Olanzapine addition in obsessive-compulsive disorder refractory to selective serotonin reuptake inhibitors; an open-label case series. J Clin Psychiatry 1999; 60: 524-7.
[43]
Francobandiera G. Olanzapine augmentation of serotonin uptake inhibitors in obsessive-compulsive disorder: an open study. Can J Psychiatry 2001; 46: 356-8.
[44]
McDougle CJ, Epperson CN, Pelton GH, et al. A double-blind, placebo-controlled study of resperidone addition in serotonin reuptake inhibitor-refractory obsessive-compulsive disorder. Arch Gen Psychiatry 2000; 57: 794-801.
[45]
Komossa K, Depping AM, Meyer M, Kissling W, Leucht S. Second-generation antipsychotics for obsessive compulsive disorder. Cochrane Database Syst Rev 2010; (12): CD008141
[46]
Matsunaga H1. Nagata T, Hayashida K, Ohya K, Kiriike N, Stein DJ. A long-term trial of the effectiveness and safety of atypical antipsychotic agents in augmenting SSRI-refractory obsessive-compulsive disorder. J Clin Psychiatry 2009; 70(6): 863-8.

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