engleski

Fluoxetine treatment of de novo obsessive compulsive symptoms in shizophrenia after clozapine treatment

Several reports have associated clozapine treatment with de novo 3r exacerbated obsessive-compulsive symptoms in schizophrenic patients. The data suggest that the effects of clozapine on serotonin neurotransmission account of these symptoms, as serotoninergic dysfunction has been implicated in obsessive- compulsive disorder. We assessed de novo obsessive-compulsive symptoms occurred in schizophrenic patients during clozapine treatment and its course after fluoxetine application. Five female and three male patients were enrolled: 1 patient with Undifferentiated Type, 2 patients with Disorganised Type, 5 with Paranoid Type of Schizophrenia, according to DSM IV. Average age was 31.7 ±5.90. Obsessions and compulsions were measured before and during fluoxetine treatment in 24-week trial. At baseline all of the patients had moderate obsessions, and seven had moderate compulsions. Subjects in trial were treated with daily doses of 40-60 mg of fluoxetine. Efficacy measures were the Yale-Brown Obsessive Compulsive Scale, CG I Obsessive Compulsive Scale, Hamilton Rating Scale for Anxiety. Statistically significant improvement was observed on all efficacy measures, based on endpoint analyses after 12 weeks, which was either showed in additional 12 weeks as a sustained improvement. Results support the safety, efficacy and tolerability of fluoxetine 40-60 mg daily doses in the acute and maintenance treatment of that particular group of schizophrenic patients.

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DOI: 10.1016/S0920-9964(97)88718-X