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Cited by 220Obsessive-Compulsive Spectrum DisordersSchizophrenia research and treatmentAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Augmentation of Serotonin Reuptake Inhibitors in Refractory Obsessive-Compulsive Disorder Using Adjunctive Olanzapine: A Placebo-Controlled Trial

Bystritsky, Alexander, Ackerman, Deborah L., Rosen, Richard M., Vapnik, Tanya, Gorbis, Eda, Maidment, Karron M., Saxena, Sanjaya·2004·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.v65n0418
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Abstract

BACKGROUND: The purpose of this study was to explore the efficacy of adding an atypical antipsychotic, olanzapine, to a serotonin reuptake inhibitor (SRI) in treatment-refractory obsessive-compulsive disorder (OCD). METHOD: Twenty-six patients aged between 18 and 65 (mean = 41.2, SD = 11.9) years meeting DSM-IV criteria for OCD, who had not responded to SRIs, were treated for 6 weeks in a double-blind, placebo-controlled augmentation study with either olanzapine (up to 20 mg/day) or placebo. Severity of illness was assessed biweekly by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Analysis of covariance with baseline Y-BOCS score included as a covariate was used to compare improvement in Y-BOCS scores in the 2 groups. Response was defined as a 25% or greater improvement in Y-BOCS score. Data were collected between April 2001 and May 2003. RESULTS: Outcome was assessed for all patients using the last observation carried forward. Subjects in the olanzapine group had a mean decrease of 4.2 (SD = 7.9) in Y-BOCS score compared with a mean increase in score of 0.54 (SD = 1.31) for subjects in the placebo group (F = 4.85, df = 2,23; p =.04). Six (46%) of 13 subjects in the olanzapine group showed a 25% or greater improvement in Y-BOCS score compared with none in the placebo group. The final mean dose of olanzapine was 11.2 (SD = 6.5) mg/day. Medication was well tolerated. Only 2 (15%) of 13 subjects who received olanzapine discontinued because of side effects: sedation (N = 1) or weight gain (N = 1). CONCLUSION: These results provide preliminary evidence that adding olanzapine to SRIs is potentially efficacious and well tolerated in the short-term treatment of patients with refractory OCD. Controlled studies with larger sample sizes are necessary to more definitively address this treatment strategy.

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  • Second-generation antipsychotic agents have shown benefit in OCD, either alone or as adjunctive therapy; high-dose olanzapine, quetiapine, and risperidone have all shown at least minimal clinical benefit relative to placebo.

    “Recently, second-generation antipsychotic agents have shown benefit, either alone or as adjunctive therapy. Specifically, high-dose olanzapine [522], quetiapine [523], and risperidone [524] have all shown at least minimal clinical benefit relative to placebo treatment [525].”

    From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [522]

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Authors
Bystritsky, A., Ackerman, D. L., Rosen, R. M., Vapnik, T., Gorbis, E., Maidment, K. M., & Saxena, S.
Affiliations
University of California, Los Angeles (US)
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2004-04-15
Volume
65
Issue
4
Pages
565-568
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.v65n0418
OpenAlex
W1988849721
Cited by
220
References
0
Citations by year
2026: 4 · 2025: 2 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 8 · 2018: 3 · 2017: 7 · 2016: 6 · 2015: 11 · 2014: 11 · 2013: 8 · 2012: 41
FWCI
23.60
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
obsessive-compulsive disorder, treatment-refractory OCD, olanzapine, serotonin reuptake inhibitors, drug augmentation, atypical antipsychotics, Yale-Brown Obsessive Compulsive Scale, drug tolerability
MeSH terms
Olanzapine, Adult, Benzodiazepines, Double-Blind Method, Drug Administration Schedule, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Placebos, Psychiatric Status Rating Scales, Severity of Illness Index, Antipsychotic Agents, Treatment Outcome, Selective Serotonin Reuptake Inhibitors

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