 |
|
A Double-blind, Placebo-Controlled Study of Risperidone Addition in Serotonin Reuptake Inhibitor–Refractory Obsessive-compulsive Disorder
Christopher J. McDougle, MD;
C. Neill Epperson, MD;
Gregory H. Pelton, MD;
Suzanne Wasylink, RNC;
Lawrence H. Price, MD
Arch Gen Psychiatry. 2000;57:794-801.
Background To date, only 1 controlled study has found a drug (haloperidol) to be efficacious in augmenting response in patients with obsessive-compulsive disorder (OCD) refractory to serotonin reuptake inhibitor (SRI) monotherapy; patients with comorbid chronic tic disorders showed a preferential response. This report describes the first controlled study of risperidone addition in patients with OCD refractory to treatment with SRI alone.
Methods Seventy adult patients with a primary DSM-IV diagnosis of OCD received 12 weeks of treatment with an SRI. Thirty-six patients were refractory to the SRI and were randomized in a double-blind manner to 6 weeks of risperidone (n = 20) or placebo (n = 16) addition. Behavioral ratings, including the Yale-Brown Obsessive Compulsive Scale, were obtained at baseline and throughout the trial. Placebo-treated patients subsequently received an identical open-label trial of risperidone addition.
Results For study completers, 9 (50%) of 18 risperidone-treated patients were responders (mean daily dose, 2.2 ±0.7 mg/d) compared with 0 of 15 in the placebo addition group (P<.005). Seven (50%) of 14 patients who received open-label risperidone addition responded. Risperidone addition was superior to placebo in reducing OCD (P<.001), depressive (P<.001), and anxiety (P = .003) symptoms. There was no difference in response between OCD patients with and without comorbid diagnoses of chronic tic disorder or schizotypal personalty disorder. Other than mild, transient sedation, risperidone was well tolerated.
Conclusion These results suggest that OCD patients with and without comorbid chronic tic disorders or schizotypal personality disorder may respond to the addition of low-dose risperidone to ongoing SRI therapy.
From the Department of Psychiatry, Section of Child and Adolescent Psychiatry, Indiana University School of Medicine, Indianapolis (Dr McDougle); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn (Dr Epperson and Ms Wasylink); Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY (Dr Pelton); and the Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, RI (Dr Price). Dr McDougle has been a paid consultant and a member of the speakers' bureau for Eli Lilly and Co, Indianapolis, Ind, and a member of the speakers' bureau for Pfizer Inc, New York, NY; Janssen Pharmaceutica, Titusville, NJ; and Solvay Pharmaceuticals, Marietta, Ga.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
A Randomized, Controlled Trial of Cognitive-Behavioral Therapy for Augmenting Pharmacotherapy in Obsessive-Compulsive Disorder
Simpson et al.
Am. J. Psychiatry 2008;165:621-630.
ABSTRACT
| FULL TEXT
Reduced orbitofrontal-striatal activity on a reversal learning task in obsessive-compulsive disorder.
Remijnse et al.
Arch Gen Psychiatry 2006;63:1225-1236.
ABSTRACT
| FULL TEXT
Obsessive-Compulsive Disorder in Tourette Syndrome
Goodman et al.
J Child Neurol 2006;21:704-714.
ABSTRACT
A review of antipsychotics in the treatment of obsessive compulsive disorder
Fineberg et al.
J Psychopharmacol 2006;20:97-103.
Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology
Baldwin et al.
J Psychopharmacol 2005;19:567-596.
ABSTRACT
Acute Onset of Obsessive-Compulsive Disorder in an Adolescent With Acute Lymphoblastic Leukemia
Morris et al.
Psychosomatics 2005;46:458-460.
FULL TEXT
Risperidone for the Core Symptom Domains of Autism: Results From the Study by the Autism Network of the Research Units on Pediatric Psychopharmacology
McDougle et al.
Am. J. Psychiatry 2005;162:1142-1148.
ABSTRACT
| FULL TEXT
Enhanced Dopamine Transporter Density in Psychotropic-Naive Patients With Obsessive-Compulsive Disorder Shown by [123I]{beta}-CIT SPECT
van der Wee et al.
Am. J. Psychiatry 2004;161:2201-2206.
ABSTRACT
| FULL TEXT
Diagnosis and Treatment of Anxiety
Bystritsky
Focus 2004;2:333-342.
ABSTRACT
| FULL TEXT
A Review of Pharmacologic Treatments for Obsessive-Compulsive Disorder
Kaplan and Hollander
Focus 2004;2:454-461.
ABSTRACT
| FULL TEXT
A Review of Pharmacologic Treatments for Obsessive-Compulsive Disorder
Kaplan and Hollander
Psychiatr. Serv. 2003;54:1111-1118.
ABSTRACT
| FULL TEXT
Mental health nurse prescribing: The research challenge
Gournay and Gray
Journal of Research in Nursing 2003;8:173-184.
ABSTRACT
Concomitant Psychotropic Medication for Youths
Safer et al.
Am. J. Psychiatry 2003;160:438-449.
ABSTRACT
| FULL TEXT
Antiobsessional Effect of Risperidone Add-On Treatment in Serotonin Reuptake Inhibitor-Refractory Obsessive-Compulsive Disorder May Be Dose-Dependent
Ramasubbu et al.
Arch Gen Psychiatry 2002;59:472-473.
FULL TEXT
A 45-Year-Old Woman With Obsessive-Compulsive Disorder
Jenike
JAMA 2001;285:2121-2128.
FULL TEXT
Other articles noted
Evid. Based Ment. Health 2001;4:8-8.
FULL TEXT
An Atypical Antipsychotic Drug in Refractory OCD
JWatch Psychiatry 2000;2000:2-2.
FULL TEXT
|
