Hypochondriasis and obsessive-compulsive disorder in schizophrenic patients treated with clozapine vs other atypical antipsychotics

Grassi, Giacomo; Poli, L.; Cantisani, Andrea; Righi, Lorenzo; Ferrari, Gabriella; Pallanti, Stefano

doi:10.1017/s1092852913000795

Cited by 6 publications

(4 citation statements)

References 43 publications

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“…Patients with schizophrenia treated with clozapine reported having a higher prevalence of hypochondriasis and OC spectrum of illnesses, and a part of this was attributed to the de novo onset or an exacerbation of existing symptoms 7. Worsening of existing symptoms occurs in a subgroup of patients with hypochondriasis/OCD, who had certain polymorphisms of SLC1A1/GRIN2B genes, whereas the de novo occurrence of OC symptoms was attributed to the role of clozapine’s strong antagonistic activities at 5-HT2A, 5-HT1C, 5-HT2C and glutamatergic receptors.…”

Section: Discussionmentioning

confidence: 99%

A case of clozapine-induced skin picking behaviour

Reddy

Das

Guruprasad³

2018

Gen Psych

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There is some evidence consistently linking the occurrence of de novo obsessive-compulsive disorder (OCD) with clozapine. This skin-picking disorder is also known as impulsive-compulsive disorder-unspecified which with an increasing convergence with OCD has been placed in the current Diagnostic and statistical manual of mental disorders-fifth edition by American Psychiatric Association (DSM-5), in the category of the obsessive-compulsive and related disorders. To the best of our knowledge, there is no literature relating antipsychotics like clozapine with the occurrence of skin-picking behaviour. In this article, we present a case in whom skin-picking behaviour emerged during the upward dose titration of clozapine and was successfully treated with escitalopram.

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Section: Discussionmentioning

confidence: 99%

A case of clozapine-induced skin picking behaviour

Reddy

Das

Guruprasad³

2018

Gen Psych

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“…As it can be understood from these similar findings, it is seen that OCD and hypochondriasis may share similar etiopathogenetic resources, and in this context, it is useful to recall previous articles on thyroid functions in OCD patients [ 3 , 8 – 10 ].…”

Section: Highlight Key Pointsmentioning

confidence: 98%

Thyroid functions in patients with hypochondriasis

Namli¹

2022

North Clin Istanbul

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OBJECTIVE No studies of thyroid-related hormone levels have been conducted in patients with hypochondriasis to date. The aim of this study is to examine thyroid-related hormones in patients with hypochondriasis. METHODS Sixty patients with hypochondriasis and 138 healthy controls were included in this study. Patients with hypochondriasis who applied to the psychiatry outpatient clinic and met the study criteria and healthy controls were determined by chart analysis. RESULTS According to the results of the comparisons, TSH, fT3, and fT4 levels did not show a statistically significant difference between hypochondriasis patients and healthy controls. CONCLUSION Thyroid hormone levels are not associated with hypochondriasis.

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“…A recent study showed that also hypochondriasis (HYPO) is more frequent in patients with SCH (20%) than in the general population (1%) and that its prevalence is higher in patients treated with CLZ (36.7%) than in those treated with other antipsychotics (6.7%) [4]. …”

Section: Introductionmentioning

confidence: 99%

Treatment of Hypochondriasis in Two Schizophrenia Patients Using Clozapine

Tundo

Proietti

Filippis

2017

Case Reports in Psychiatry

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Hypochondriasis (HYPO), an obsessive-compulsive spectrum disorder, is frequent in patients with schizophrenia (SCH) (20%), especially among those treated with clozapine (36.7%). Treatment options for OCS/OCD in patients under clozapine (CLZ) include combining clozapine with amisulpride/aripiprazole or a mood stabilizer, augmenting clozapine with a serotoninergic reuptake inhibitor, adding cognitive behavioural therapy, and gradually reducing dosage. No treatments have been proposed for HYPO in patients using clozapine so we examine these options in 2 cases and report the results. Among treatments delivered, only dosage reduction adequately worked. We recommend caution when thinking about escalating treatment and suggest trying it only when alternative interventions were not successful and weighing risk and benefits of this therapeutic strategy. Further research is needed to confirm the hypothesis that CLZ treatment induces hypochondriac symptoms, to investigate the prevalence of the phenomenon, and, mostly, to identify possible treatment strategies.

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Hypochondriasis and obsessive-compulsive disorder in schizophrenic patients treated with clozapine vs other atypical antipsychotics

Abstract: Hypochondriasis could represent an important clinical feature of schizophrenic patients treated with atypical antipsychotics, and further research is needed in this field.

Cited by 6 publications

References 43 publications

A case of clozapine-induced skin picking behaviour

A case of clozapine-induced skin picking behaviour

Thyroid functions in patients with hypochondriasis

Treatment of Hypochondriasis in Two Schizophrenia Patients Using Clozapine

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