Olanzapine augmentation of fluvoxamine-refractory obsessive–compulsive disorder (OCD): a 12-week open trial

Bogetto, Filippo; Bellino, Silvio; Vaschetto, P.; Ziero, Simona

doi:10.1016/s0165-1781(00)00203-1

Cited by 106 publications

(59 citation statements)

References 42 publications

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“…Several open-label studies have also found that a relatively low dose of olanzapine (5 mg) improves the symptoms of patients with OCD who were refractory to SSRIs (Weiss et al, 1999;Bogetto et al, 2000). However, all of the patients from Bogetto et al and 5/8 positive responders from Weiss et al were treated with fluvoxamine, which could have elevated olanzapine levels by interactions with cytochrome P450 microsomal isoenzymes.…”

Section: Olanzapine: Clinical Activity In Major Depression Ocd and Pddmentioning

confidence: 99%

Synergistic Action of 5-HT2A Antagonists and Selective Serotonin Reuptake Inhibitors in Neuropsychiatric Disorders

Marek

Carpenter

McDougle

et al. 2002

Neuropsychopharmacol

241

120

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Recently, the addition of drugs with prominent 5-HT 2 receptor antagonist properties (risperidone, olanzapine, mirtazapine, and mianserin) to selective serotonin reuptake inhibitors (SSRIs) has been shown to enhance therapeutic responses in patients with major depression and treatment-refractory obsessive-compulsive disorder (OCD). These 5-HT 2 antagonists may also be effective in ameliorating some symptoms associated with autism and other pervasive developmental disorders (PDDs). At the doses used, these drugs would be expected to saturate 5-HT 2A receptors. These findings suggest that the simultaneous blockade of 5-HT 2A

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Section: Olanzapine: Clinical Activity In Major Depression Ocd and Pddmentioning

confidence: 99%

Synergistic Action of 5-HT2A Antagonists and Selective Serotonin Reuptake Inhibitors in Neuropsychiatric Disorders

Marek

Carpenter

McDougle

et al. 2002

Neuropsychopharmacol

241

120

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“…In long-term and relapse prevention studies, escitalopram, fluoxetine, paroxetine, sertraline and clomipramine were superior to placebo (see above for references). Within the limits of the acute treatment phase, response to treatment with SSRIs is characteristi- SSRI Pallanti et al 1999 Yes (C1) Addition of an SSRI to clomipramine Ravizza et al 1996 Yes (C1) Adding lithium to clomipramine * Rasmussen 1984 Yes (C1) Addition of buspirone to an* SSRI Jenike et al 1991b;Markovitz et al 1990 Yes (C1) Addition of topiramate to an SSRI Hollander and Dell'Osso, 2006;Van Ameringen et al 2006 Yes (C1) Addition of N-acetylcysteine to an SSRI Lafleur et al 2006 Yes (C2) Addition of atypical antipsychotics Á aripiprazole Á olanzapine, Á perospirone, Á quetiapine, or Á risperidone, to an SSRI or clomipramine Agid and Lerer 1999; Atmaca et al 2002;Bogan et al 2005;Bogetto et al 2000;da Rocha and Correa 2007;Dell'Osso et al 2006;Francobandiera, 2001;Friedman et al 2007b;Kawahara et al 2000;Koran et al 2000;Marazziti and Pallanti 1999;Marazziti et al 2005;Mohr et al 2002;Otsuka et al 2007;Pfanner et al 2000;Ravizza et al 1996;Saxena et al 1996;Stein et al 1997;Storch et al 2008;Weiss et al 1999;Yoshimura et al 2006 Yes (C1) cally partial. Between 30 and 60% cases in acute phase DBPC studies reached a clinically relevant level of improvement.…”

Section: Other Medicationsmentioning

confidence: 99%

“…The subgroup of OCD patients with comorbid tics had a particularly beneficial response to this intervention. Other patients that had benefit from the combination were those with poor insight (Hollander et al 2003b) and co-occurring schizotypal personality disorder (Bogetto et al 2000;McDougle et al 1990). There is also evidence suggesting OCD patients should be treated with at least 3 months of maximaltolerated therapy of an SSRI before initiating antipsychotic augmentation owing to the high rate of treatment response to continued SSRI monotherapy.…”

Section: Treatment-resistantmentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

718

410

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In this report, which is an update of a guideline published in 2002 (Bandelow et al. 2002, recommendations for the pharmacological treatment of anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are presented. Since the publication of the first version of this guideline, a substantial number of new randomized controlled studies of anxiolytics have been published. In particular, more relapse prevention studies are now available that show sustained efficacy of anxiolytic drugs. The recommendations, developed by the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders, a consensus panel of 30 international experts, are now based on 510 published randomized, placebo-or comparator-controlled clinical studies (RCTs) and 130 open studies and case reports. First-line treatments for these disorders are selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs) and the calcium channel modulator pregabalin. Tricyclic antidepressants (TCAs) are equally effective for some disorders, but many are less well tolerated than the SSRIs/ SNRIs. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of substance abuse disorders. Potential treatment options for patients unresponsive to standard treatments are described in this overview. Although these guidelines focus on medications, non-pharmacological were also considered. Cognitive behavioural therapy (CBT) and other variants of behaviour therapy have been sufficiently investigated in controlled studies in patients with anxiety disorders, OCD, and PTSD to support them being recommended either alone or in combination with the above medicines.

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“…Perhaps, treatment for these patients should skip ''solo'' SSRI treatment and start directly with combination with neuroleptics; only after that treatment could the patient be considered nonresponsive to adequate treatment. Adequate treatment utilizing other categories of drugs for specific subtypes should also be evaluated: for example, patients with prevalent symmetry and atypical obsessions or high level of anxiety to treatment may warrant the use of a MAOI (Jenike et al, 1997) or NSRI (Grossman and Hollander, 1996), and/or augmentation with atypical neuroleptics such as risperidone (McDougle et al, 2000) and olanzapine (Bogetto et al, 2000;Koran et al, 2000) before declaring a patient non-responsive. Highly anxious obsessional subjects could also be treated with a combination of benzodiazepines (i.e., clonazepam) and an SSRI (Hewlett et al, 1990(Hewlett et al, , 1992.…”

Section: Subtypesmentioning

confidence: 99%

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Pallanti

Quercioli

2006

Progress in Neuro-Psychopharmacology and Biological Psychiatry

337

190

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While controlled trials with SRIs have demonstrated a selective efficacy in obsessive-compulsive disorder (OCD), up to 40 -60% of patients do not have a satisfactory outcome. Non-response to treatment in OCD is associated with serious social disability. There are a large number of nonresponsive patients, and they are difficult to cluster due to ambiguities in diagnostic criteria, possibility of subtypes and a high rate of comorbidity. Moreover, the findings of current studies of ''so-called'' non-responsive cases are currently non-generalizable because of the lack of an operational definition of non-response. The result has been that a cumulative body of data on a reasonably homogeneous sample of non-responders has not been developed. The aims of the research in this area are to clarify some of the obstacles in defining stages of response and levels of non-response and, through a comprehensive analysis, to propose a systematic nosology for this rather common condition. Better characterization of which patients respond and do not respond to various treatments will enable more accurate clustering of patients, and help facilitate multisite data collection for future research trials. The authors reviewed also the more recent therapeutic pharmacological and psychological lines for the treatment of refractoriness in OCD. D

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Olanzapine augmentation of fluvoxamine-refractory obsessive–compulsive disorder (OCD): a 12-week open trial

Cited by 106 publications

References 42 publications

Synergistic Action of 5-HT2A Antagonists and Selective Serotonin Reuptake Inhibitors in Neuropsychiatric Disorders

Synergistic Action of 5-HT2A Antagonists and Selective Serotonin Reuptake Inhibitors in Neuropsychiatric Disorders

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

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