A Double-blind, Placebo-Controlled Study of Risperidone Addition in Serotonin Reuptake Inhibitor–Refractory Obsessive-compulsive Disorder
BACKGROUND To date, only 1 controlled study has found a drug (haloperidol) to be efficacious in augmenting response in patients with obsessive-compulsive disorder (OCD) refractory to serotonin reuptake inhibitor (SRI) monotherapy; patients with comorbid chronic tic disorders showed a preferential re...
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| Veröffentlicht in: | Archives of general psychiatry 2000-08, Vol.57 (8), p.794-801 |
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| creator | McDougle, Christopher J Epperson, C. Neill Pelton, Gregory H Wasylink, Suzanne Price, Lawrence H |
| description | BACKGROUND To date, only 1 controlled study has found a drug (haloperidol) to be efficacious in augmenting response in patients with obsessive-compulsive disorder (OCD) refractory to serotonin reuptake inhibitor (SRI) monotherapy; patients with comorbid chronic tic disorders showed a preferential response. This report describes the first controlled study of risperidone addition in patients with OCD refractory to treatment with SRI alone. METHODS Seventy adult patients with a primary DSM-IV diagnosis of OCD received 12 weeks of treatment with an SRI. Thirty-six patients were refractory to the SRI and were randomized in a double-blind manner to 6 weeks of risperidone (n = 20) or placebo (n = 16) addition. Behavioral ratings, including the Yale-Brown Obsessive Compulsive Scale, were obtained at baseline and throughout the trial. Placebo-treated patients subsequently received an identical open-label trial of risperidone addition. RESULTS For study completers, 9 (50%) of 18 risperidone-treated patients were responders (mean daily dose, 2.2 ±0.7 mg/d) compared with 0 of 15 in the placebo addition group (P |
| doi_str_mv | 10.1001/archpsyc.57.8.794 |
| format | Article |
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Neill ; Pelton, Gregory H ; Wasylink, Suzanne ; Price, Lawrence H</creator><creatorcontrib>McDougle, Christopher J ; Epperson, C. Neill ; Pelton, Gregory H ; Wasylink, Suzanne ; Price, Lawrence H</creatorcontrib><description>BACKGROUND To date, only 1 controlled study has found a drug (haloperidol) to be efficacious in augmenting response in patients with obsessive-compulsive disorder (OCD) refractory to serotonin reuptake inhibitor (SRI) monotherapy; patients with comorbid chronic tic disorders showed a preferential response. This report describes the first controlled study of risperidone addition in patients with OCD refractory to treatment with SRI alone. METHODS Seventy adult patients with a primary DSM-IV diagnosis of OCD received 12 weeks of treatment with an SRI. Thirty-six patients were refractory to the SRI and were randomized in a double-blind manner to 6 weeks of risperidone (n = 20) or placebo (n = 16) addition. Behavioral ratings, including the Yale-Brown Obsessive Compulsive Scale, were obtained at baseline and throughout the trial. Placebo-treated patients subsequently received an identical open-label trial of risperidone addition. RESULTS For study completers, 9 (50%) of 18 risperidone-treated patients were responders (mean daily dose, 2.2 ±0.7 mg/d) compared with 0 of 15 in the placebo addition group (P<.005). Seven (50%) of 14 patients who received open-label risperidone addition responded. Risperidone addition was superior to placebo in reducing OCD (P<.001), depressive (P<.001), and anxiety (P = .003) symptoms. There was no difference in response between OCD patients with and without comorbid diagnoses of chronic tic disorder or schizotypal personalty disorder. Other than mild, transient sedation, risperidone was well tolerated. CONCLUSION These results suggest that OCD patients with and without comorbid chronic tic disorders or schizotypal personality disorder may respond to the addition of low-dose risperidone to ongoing SRI therapy.Arch Gen Psychiatry. 2000;57:794-801--></description><identifier>ISSN: 0003-990X</identifier><identifier>EISSN: 1538-3636</identifier><identifier>DOI: 10.1001/archpsyc.57.8.794</identifier><identifier>PMID: 10920469</identifier><identifier>CODEN: ARGPAQ</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Adult ; Antipsychotic Agents - administration & dosage ; Antipsychotic Agents - therapeutic use ; Biological and medical sciences ; Comorbidity ; Dopamine Antagonists - therapeutic use ; Double-Blind Method ; Drug Administration Schedule ; Drug Therapy, Combination ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Neuropharmacology ; Obsessive-Compulsive Disorder - drug therapy ; Obsessive-Compulsive Disorder - epidemiology ; Obsessive-Compulsive Disorder - psychology ; Pharmacology. Drug treatments ; Placebos ; Psycholeptics: tranquillizer, neuroleptic ; Psychology. Psychoanalysis. Psychiatry ; Psychopharmacology ; Risperidone - administration & dosage ; Risperidone - therapeutic use ; Schizotypal Personality Disorder - drug therapy ; Schizotypal Personality Disorder - epidemiology ; Serotonin Antagonists - therapeutic use ; Serotonin Uptake Inhibitors - therapeutic use ; Tics - drug therapy ; Tics - epidemiology ; Treatment Outcome</subject><ispartof>Archives of general psychiatry, 2000-08, Vol.57 (8), p.794-801</ispartof><rights>2000 INIST-CNRS</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a410t-3c0bd443026a4d5dbdb0a0eb99e2db97af9be0f5c39f6ef2eec7b39dd434c9303</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamapsychiatry/articlepdf/10.1001/archpsyc.57.8.794$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archpsyc.57.8.794$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,780,784,3340,27924,27925,76489,76492</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1462240$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10920469$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McDougle, Christopher J</creatorcontrib><creatorcontrib>Epperson, C. Neill</creatorcontrib><creatorcontrib>Pelton, Gregory H</creatorcontrib><creatorcontrib>Wasylink, Suzanne</creatorcontrib><creatorcontrib>Price, Lawrence H</creatorcontrib><title>A Double-blind, Placebo-Controlled Study of Risperidone Addition in Serotonin Reuptake Inhibitor–Refractory Obsessive-compulsive Disorder</title><title>Archives of general psychiatry</title><addtitle>Arch Gen Psychiatry</addtitle><description>BACKGROUND To date, only 1 controlled study has found a drug (haloperidol) to be efficacious in augmenting response in patients with obsessive-compulsive disorder (OCD) refractory to serotonin reuptake inhibitor (SRI) monotherapy; patients with comorbid chronic tic disorders showed a preferential response. This report describes the first controlled study of risperidone addition in patients with OCD refractory to treatment with SRI alone. METHODS Seventy adult patients with a primary DSM-IV diagnosis of OCD received 12 weeks of treatment with an SRI. Thirty-six patients were refractory to the SRI and were randomized in a double-blind manner to 6 weeks of risperidone (n = 20) or placebo (n = 16) addition. Behavioral ratings, including the Yale-Brown Obsessive Compulsive Scale, were obtained at baseline and throughout the trial. Placebo-treated patients subsequently received an identical open-label trial of risperidone addition. RESULTS For study completers, 9 (50%) of 18 risperidone-treated patients were responders (mean daily dose, 2.2 ±0.7 mg/d) compared with 0 of 15 in the placebo addition group (P<.005). Seven (50%) of 14 patients who received open-label risperidone addition responded. Risperidone addition was superior to placebo in reducing OCD (P<.001), depressive (P<.001), and anxiety (P = .003) symptoms. There was no difference in response between OCD patients with and without comorbid diagnoses of chronic tic disorder or schizotypal personalty disorder. Other than mild, transient sedation, risperidone was well tolerated. CONCLUSION These results suggest that OCD patients with and without comorbid chronic tic disorders or schizotypal personality disorder may respond to the addition of low-dose risperidone to ongoing SRI therapy.Arch Gen Psychiatry. 2000;57:794-801--></description><subject>Adult</subject><subject>Antipsychotic Agents - administration & dosage</subject><subject>Antipsychotic Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Comorbidity</subject><subject>Dopamine Antagonists - therapeutic use</subject><subject>Double-Blind Method</subject><subject>Drug Administration Schedule</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neuropharmacology</subject><subject>Obsessive-Compulsive Disorder - drug therapy</subject><subject>Obsessive-Compulsive Disorder - epidemiology</subject><subject>Obsessive-Compulsive Disorder - psychology</subject><subject>Pharmacology. 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Psychiatry</subject><subject>Psychopharmacology</subject><subject>Risperidone - administration & dosage</subject><subject>Risperidone - therapeutic use</subject><subject>Schizotypal Personality Disorder - drug therapy</subject><subject>Schizotypal Personality Disorder - epidemiology</subject><subject>Serotonin Antagonists - therapeutic use</subject><subject>Serotonin Uptake Inhibitors - therapeutic use</subject><subject>Tics - drug therapy</subject><subject>Tics - epidemiology</subject><subject>Treatment Outcome</subject><issn>0003-990X</issn><issn>1538-3636</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkU1v1DAQhi1ERZfCD-gF-YB6Iss4dpL1cbXlo1KlVluQuFn-mKgGJw52grQ37hz5h_wSstot5TTvaJ4Zjd6XkHMGSwbA3upk74e8s8uqWa6WjRRPyIJVfFXwmtdPyQIAeCElfDklz3P-OrdQ1eUzcspAliBquSC_1vQyTiZgYYLv3Rt6G7RFE4tN7McUQ0BH78bJ7Whs6dbnAZN3sUe6ds6PPvbU9_QOUxxjP6stTsOovyG96u-98WNMf37-3mKbtJ31jt6YjDn7H1jY2A1T2Et66XNMDtMLctLqkPHlsZ6Rz-_ffdp8LK5vPlxt1teFFgzGglswTggOZa2Fq5xxBjSgkRJLZ2SjW2kQ2spy2dbYloi2MVw6J7iwkgM_IxeHu0OK3yfMo-p8thiC7jFOWTWsFE1TyRlkB9CmmHPCVg3JdzrtFAO1T0A9JKCqRq3UnMC88-p4fDIduv82DpbPwOsjoLPVYbamtz4_cqIuS7F_8vyA6U7_G4oVqwXjfwGZBZ4n</recordid><startdate>20000801</startdate><enddate>20000801</enddate><creator>McDougle, Christopher J</creator><creator>Epperson, C. 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Drug treatments</topic><topic>Placebos</topic><topic>Psycholeptics: tranquillizer, neuroleptic</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Risperidone - administration & dosage</topic><topic>Risperidone - therapeutic use</topic><topic>Schizotypal Personality Disorder - drug therapy</topic><topic>Schizotypal Personality Disorder - epidemiology</topic><topic>Serotonin Antagonists - therapeutic use</topic><topic>Serotonin Uptake Inhibitors - therapeutic use</topic><topic>Tics - drug therapy</topic><topic>Tics - epidemiology</topic><topic>Treatment Outcome</topic><toplevel>online_resources</toplevel><creatorcontrib>McDougle, Christopher J</creatorcontrib><creatorcontrib>Epperson, C. Neill</creatorcontrib><creatorcontrib>Pelton, Gregory H</creatorcontrib><creatorcontrib>Wasylink, Suzanne</creatorcontrib><creatorcontrib>Price, Lawrence H</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of general psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McDougle, Christopher J</au><au>Epperson, C. Neill</au><au>Pelton, Gregory H</au><au>Wasylink, Suzanne</au><au>Price, Lawrence H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Double-blind, Placebo-Controlled Study of Risperidone Addition in Serotonin Reuptake Inhibitor–Refractory Obsessive-compulsive Disorder</atitle><jtitle>Archives of general psychiatry</jtitle><addtitle>Arch Gen Psychiatry</addtitle><date>2000-08-01</date><risdate>2000</risdate><volume>57</volume><issue>8</issue><spage>794</spage><epage>801</epage><pages>794-801</pages><issn>0003-990X</issn><eissn>1538-3636</eissn><coden>ARGPAQ</coden><abstract>BACKGROUND To date, only 1 controlled study has found a drug (haloperidol) to be efficacious in augmenting response in patients with obsessive-compulsive disorder (OCD) refractory to serotonin reuptake inhibitor (SRI) monotherapy; patients with comorbid chronic tic disorders showed a preferential response. This report describes the first controlled study of risperidone addition in patients with OCD refractory to treatment with SRI alone. METHODS Seventy adult patients with a primary DSM-IV diagnosis of OCD received 12 weeks of treatment with an SRI. Thirty-six patients were refractory to the SRI and were randomized in a double-blind manner to 6 weeks of risperidone (n = 20) or placebo (n = 16) addition. Behavioral ratings, including the Yale-Brown Obsessive Compulsive Scale, were obtained at baseline and throughout the trial. Placebo-treated patients subsequently received an identical open-label trial of risperidone addition. RESULTS For study completers, 9 (50%) of 18 risperidone-treated patients were responders (mean daily dose, 2.2 ±0.7 mg/d) compared with 0 of 15 in the placebo addition group (P<.005). Seven (50%) of 14 patients who received open-label risperidone addition responded. Risperidone addition was superior to placebo in reducing OCD (P<.001), depressive (P<.001), and anxiety (P = .003) symptoms. There was no difference in response between OCD patients with and without comorbid diagnoses of chronic tic disorder or schizotypal personalty disorder. Other than mild, transient sedation, risperidone was well tolerated. CONCLUSION These results suggest that OCD patients with and without comorbid chronic tic disorders or schizotypal personality disorder may respond to the addition of low-dose risperidone to ongoing SRI therapy.Arch Gen Psychiatry. 2000;57:794-801--></abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>10920469</pmid><doi>10.1001/archpsyc.57.8.794</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Antipsychotic Agents - administration & dosage Antipsychotic Agents - therapeutic use Biological and medical sciences Comorbidity Dopamine Antagonists - therapeutic use Double-Blind Method Drug Administration Schedule Drug Therapy, Combination Female Humans Male Medical sciences Middle Aged Neuropharmacology Obsessive-Compulsive Disorder - drug therapy Obsessive-Compulsive Disorder - epidemiology Obsessive-Compulsive Disorder - psychology Pharmacology. Drug treatments Placebos Psycholeptics: tranquillizer, neuroleptic Psychology. Psychoanalysis. Psychiatry Psychopharmacology Risperidone - administration & dosage Risperidone - therapeutic use Schizotypal Personality Disorder - drug therapy Schizotypal Personality Disorder - epidemiology Serotonin Antagonists - therapeutic use Serotonin Uptake Inhibitors - therapeutic use Tics - drug therapy Tics - epidemiology Treatment Outcome |
| title | A Double-blind, Placebo-Controlled Study of Risperidone Addition in Serotonin Reuptake Inhibitor–Refractory Obsessive-compulsive Disorder |
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