More threads by David Baxter PhD

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


That sounds very promising. It's so good to see that the extrapyramidal effects have been all but eliminated in treating mental illness. Those were just NOT GOOD!


Resident Canuck
I was on Risperidal, I believe it is the same thing????

I understood at the time, why I was given it. I had about a month of racing and intrusive thoughts that I could not handle. It prevented me from sleeping mostly and I couldn't concentrate on things. I got confused doing routine things at work.

I was taken off work for 2 weeks during the start of Risperidal. Started on 1mg and then was dropped the second week to .5mg.

The worst side effect was weight gain. I went from {{Edit: specific weight references}} within 4 months, but I knew I had to worry about my mental health.

I stayed on it for a few years. When the impulsiveness got bad, I would take an extra bit to slow my brain down.

I am not sure it would be an option for all symptoms of OCD. That would be up to your doctor.

I am no longer on Risperidal. I was able to ween off it no problem, but I was also able to ween off Effexor XR as well with very little problem. I read horror stories about people trying to go off Effexor, so I wouldn't want anyone to assume that coming off Risperidal is easy, as I can only say for myself. But it is an anti-psychotic.
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After relatively successful 7 months on Lexapro (Cipralex), my PDoc has suggested that I go on Risperidone .5-1mg to augment my SSRI treatment. I had been doing so well and must give thanks to Lexapro for bringing me out of a very dark hole caused by my pure-o OCD. I had many months during the initial phases of Lexapro treatment where I didn't even think about my OCD. Unfortunately, I'm now past the max dose (30mg) and need to add something as my intrusive obsessive thoughts and anxiety are creeping back in.

I'm scared to take this med as I've very active - I play ball hockey, ski and love to jog. I don't want to be all medicated and sedated. I've also got a job which requires me to be very sharp. I was thinking of giving it a try, but was wondering if maybe a more standard SSRI for OCD might help - like Luvox or Anafranil.

Anyone else have experience with Risperidone? Does it make you so you can't function?

Obviously, I'm obsessing over it, so I need to make a decision either way.



My daughter is being treated with this drug and she says it is the only medication that has helped her racing thoughts Her new doctor is now giving it by injection and has seen improvement I think going with what your doctor suggest would be wise and see if it is helpful if not you can let Dr. know but it has helped my daughter and my brother as well take care.


So I took the Risperidone for about two months. It was kind of sedating at first, then didn't seem to do much at all. I suppose it did curb my anxiety somewhat for a while.

Now I'm moving on to Seroquel. I tried 25 mg a few days ago and slept like a log.

Sometimes I wonder if all these meds are holding me back from true recovery because they are just masking the real problem and I'm unable to face it head on, on my own.

I'm actively using CBT.

I've been on AD's for a year now. I've improved slightly, but basically I'm nowhere near where I want to be.
I don't know if they are holding you back Ithink they are keeping you stable so you are able to face the problems head on. Without them the anxiety might be too much to handle Both meds and therapy tend to work best for recovery take care.
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