Olanzapine Augmentation for Treatment-Resistant Obsessive-Compulsive Disorder
J Clin Psychiatry 2000;61(7):514-517
© Copyright 2014 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Adding the atypical neuroleptic
risperidone to a serotonin reuptake inhibitor (SRI) has benefited
patients with treatment-refractory obsessive-compulsive disorder
(OCD). Since olanzapine and risperidone have similar serotonergic
and dopaminergic receptor binding profiles, we tested the
hypothesis that olanzapine augmentation would be beneficial in
Method: For this 8-week trial, we recruited 10
adult OCD patients (DSM-IV criteria) unresponsive to fluoxetine
(>= 60 mg/day) for >= 10 weeks, which was continued
throughout the trial. Other psychotropic medications were
discontinued. Subjects had OCD for >= 1 year, a Yale-Brown
Obsessive Compulsive Scale (Y-BOCS) score of >= 18, and no
organic, psychotic, or other primary Axis I disorder. Two weeks
after olanzapine, 2.5 mg/day, was added, and in the absence of
responder status (Y-BOCS score decrease >= 25%) and limiting
side effects, we increased the dose to 5 mg/day, and after 2 more
weeks, to 10 mg/day for 4 weeks.
Results: The subjects had failed a mean of 3.3
SRI trials (range, 1-5) and had a mean ± SD baseline Y-BOCS
score of 29.0 ± 4.9. Nine patients completed the trial. The
subjects' mean ± SD endpoint Y-BOCS score was 24.4 ± 8.0 (a 16%
decrease). The 3 responders' Y-BOCS scores dropped 68%, 30%, and
29%, but only 1 patient was rated "much improved." He
maintained this improvement during a 6-month follow-up period
taking olanzapine, 5 mg/day. Improvement in OCD was independent
of improvement in mood symptoms. Six patients (60%) experienced
significant weight gain.
Conclusion: Olanzapine augmentation may benefit
treatment-unresponsive OCD. Double-blind, placebo-controlled
trials are warranted along with trials comparing risperidone and