Effect of Aripiprazole Augmentation of Serotonin Reuptake Inhibitors or Clomipramine in Treatment-Resistant Obsessive-Compulsive Disorder

Abstract

Based on the evidence that aripiprazole added to serotonin reuptake inhibitors (SRIs) or clomipramine in treatment-resistant obsessive-compulsive disorder (OCD) has reported promising results, the present 16-week, double-blind, randomized, placebo-controlled trial had the aim to explore the efficacy of aripiprazole add-on pharmacotherapy on clinical symptoms and cognitive functioning in a sample of treatment-resistant OCD patients receiving SRIs. After clinical and neurocognitive assessments, patients were randomly allocated to receive, in a double-blind design, 15 mg/d of aripiprazole or a placebo. A final sample of 30 patients completed the study. The results obtained indicate that aripiprazole added to stable SRI treatment substantially improved obsessive-compulsive symptoms as measured by changes on the Yale-Brown Obsessive Compulsive Scale total score and subscores (obsessions, P = 0.007; compulsions, P = 0.001; total score, P < 0.0001). Regarding cognitive functions, improvement was observed in some explored areas, such as attentional resistance to interference (Stroop score, P = 0.001) and executive functioning (perseverative errors, P = 0.015). The findings provide evidence that aripiprazole augmentation of SRIs/clomipramine treatment is well tolerated and may be proposed as an effective therapeutic strategy to improve outcome in treatment-resistant OCD.

Aripiprazole augmentation of clomipramine therapy in treatment-resistant obsessive-compulsive disorder: case series

“…This can be explained by diverse pharmacological mechanisms of aripiprazole (25). Results of a double-blind, randomized, placebo controlled study supported the notion that adding aripiprazole to SSRIs could be a valid strategy for treatment-resistant OCD patients (26,27). Another study performed on 30 subjects provided evidences that aripiprazole augmentation of clomipramine treatment was well tolerated, and might be proposed as an effective therapeutic strategy to improve outcome in treatment-resistant OCD (27).…”

“…Results of a double-blind, randomized, placebo controlled study supported the notion that adding aripiprazole to SSRIs could be a valid strategy for treatment-resistant OCD patients (26,27). Another study performed on 30 subjects provided evidences that aripiprazole augmentation of clomipramine treatment was well tolerated, and might be proposed as an effective therapeutic strategy to improve outcome in treatment-resistant OCD (27). Successful treatment result in an OCD subject with treatment of escitalopram and aripiprazole proved that dopaminergic pathways might play an important role in OCD pathogenesis as well as serotonergic pathways, and that imbalance between these pathways might cause this disorder.…”

Pharmacotherapy of obsessive-compulsive disorder during pregnancy: a clinical approach

“…Aripiprazole has been studied in two positive double-blinded clinical trials and a single-blinded randomized study with results that favor the use of aripiprazole. [104][105][106] A meta-analysis by Dold et al 100 including a double-blinded study with aripiprazole reported that the results were inconsistent. Conversely, new Canadian clinical practice guidelines recommend the use of aripiprazole in addition to risperidone as first-line adjunctive therapy.…”

Augmentation strategies in obsessive–compulsive disorder

“…Data from multiple case series [52,53] and two placebo-controlled RCTs [21,54] have demonstrated the efficacy of aripiprazole augmentation in treatment-resistant OCD.…”