David Baxter PhD
Late Founder
Risperidone as add-on therapy improves OCD treatment response
January 20, 2005
Adding just a low-dose of risperidone to serotonin reuptake inhibitor (SRI) treatment appears to be effective for improving response in patients with treatment-resistant obsessive-compulsive disorder (OCD), researchers report.
"At the present time, a major concern in the clinical psychopharmacology of OCD is the number of nonresponders to drug therapy," observe Stefano Erzegovesi and colleagues from Vita-Salute San Raffaele University in Milan, Italy.
As many as 40-60% of patients treated with SRIs at adequate dosages fail to show improvement, which has led to a growing interest in the possible benefits of add-on therapies.
For their study, the researchers investigated the efficacy of risperidone as such a therapy in 39 OCD patients, of whom nine had responded to 12 weeks of treatment with fluvoxamine, while 10 had not.
The participants received placebo or 0.5 mg of risperidone in addition to fluvoxamine for a further 6 weeks, in a double-blind study design.
The results, published in the journal European Neuropsychopharmacology, showed a significant effect of risperidone addition after 18 weeks, but only for fluvoxamine-refractory patients. During the double-blind phase, five (50%) patients taking risperidone, and two (20%) of those given placebo became responders, with a decrease in Yale-Brown Obsessive-Compulsive Scale score of 35% or more.
In contrast, for patients who had responded to fluvoxamine in the initial 12-week trial, the addition of risperidone appeared to weaken the therapeutic effect of the SRI, compared with placebo.
Risperidone was generally well tolerated, except for mild transient sedation and a mild increase in appetite. There was no evidence of extrapyramidal effects.
"This preliminary study suggests that even very low risperidone doses are effective in OCD patients who were nonresponders to a standardized treatment with fluvoxamine," the team writes.
"Prospective long-term studies on larger samples will be useful to identify possible correlations between clinical characteristics and response to SRIs and thus to define which subtypes of OCD could take more advantage of add-on treatments."
Eur Neuropsychopharmacol 2005; 15: 69-74
January 20, 2005
Adding just a low-dose of risperidone to serotonin reuptake inhibitor (SRI) treatment appears to be effective for improving response in patients with treatment-resistant obsessive-compulsive disorder (OCD), researchers report.
"At the present time, a major concern in the clinical psychopharmacology of OCD is the number of nonresponders to drug therapy," observe Stefano Erzegovesi and colleagues from Vita-Salute San Raffaele University in Milan, Italy.
As many as 40-60% of patients treated with SRIs at adequate dosages fail to show improvement, which has led to a growing interest in the possible benefits of add-on therapies.
For their study, the researchers investigated the efficacy of risperidone as such a therapy in 39 OCD patients, of whom nine had responded to 12 weeks of treatment with fluvoxamine, while 10 had not.
The participants received placebo or 0.5 mg of risperidone in addition to fluvoxamine for a further 6 weeks, in a double-blind study design.
The results, published in the journal European Neuropsychopharmacology, showed a significant effect of risperidone addition after 18 weeks, but only for fluvoxamine-refractory patients. During the double-blind phase, five (50%) patients taking risperidone, and two (20%) of those given placebo became responders, with a decrease in Yale-Brown Obsessive-Compulsive Scale score of 35% or more.
In contrast, for patients who had responded to fluvoxamine in the initial 12-week trial, the addition of risperidone appeared to weaken the therapeutic effect of the SRI, compared with placebo.
Risperidone was generally well tolerated, except for mild transient sedation and a mild increase in appetite. There was no evidence of extrapyramidal effects.
"This preliminary study suggests that even very low risperidone doses are effective in OCD patients who were nonresponders to a standardized treatment with fluvoxamine," the team writes.
"Prospective long-term studies on larger samples will be useful to identify possible correlations between clinical characteristics and response to SRIs and thus to define which subtypes of OCD could take more advantage of add-on treatments."
Eur Neuropsychopharmacol 2005; 15: 69-74
