The DOI matches its Crossref record.
Augmentation of Serotonin Reuptake Inhibitors in Refractory Obsessive-Compulsive Disorder Using Adjunctive Olanzapine: A Placebo-Controlled Trial
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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“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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Psychiatric Comorbidities and Schizophrenia
Buckley, P. F., Miller, B. J., Lehrer, D. S., & Castle, D. J. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbn135 · Cited by 1,121
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090
“including olanzapine (Level 1, conflicting) [760,762,763],”
BackgroundPractice Guideline for the Treatment of Patients With Obsessive-Compulsive Disorder
(2008) · APA Practice Guidelines for the Treatment of Psychiatric Disorders: Comprehensive Guidelines and Guideline Watches · doi:10.1176/appi.books.9780890423363.149114 · Cited by 1,028
Bandelow, B., Zohar, J., Hollander, E., Kasper, S., Möller, H., & WFSBP Task Force on Treatment Guide (2008) · The World Journal of Biological Psychiatry · doi:10.1080/15622970802465807 · Cited by 887
“In DBPC studies, the combination of the atypical antipsychotics quetiapine, olanzapine and risperidone with an SSRI was more effective than SSRI monotherapy (Bystritsky et al. 2004; Denys et al. 2004a; Erzegovesi et al. 2005; Hollander et al. 2003b; McDougle et al. 2000; Shapira et al. 2004)(B).”
BackgroundBloch, M. H., Landeros-Weisenberger, A., Kelmendi, B., Coric, V, Bracken, M. B., & Leckman, J. F. (2006) · Molecular Psychiatry · doi:10.1038/sj.mp.4001823 · Cited by 635
Metadata
- 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)
- 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)
- 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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