Management of schizophrenia with obsessive-compulsive features

The Psychiatric Clinics of North America
Michael Y HwangLewis A Opler

Abstract

Although obsessive-compulsive symptoms (OCS) in schizophrenia have been conceptually controversial and clinically challenging, recent evidence suggests that schizophrenia with OCS may constitute a distinct schizophrenic subgroup. Recent epidemiological and clinical findings have shown that the subgroup obsessive-compulsive (OC) schizophrenia is associated with poor outcome and is more frequent than previously realized. Emerging biological evidence suggests that OCS in schizophrenia has more than one pathogenesis, with distinct mechanisms that may require different treatment interventions. Therefore, the management of OCS in patients with schizophrenia requires an individualized treatment approach based on the pathogenesis and clinical status of the patient. For example, the atypical antipsychotics that are potent serotonin antagonists sometimes induce de novo or exacerbate preexisting OCS, which resolves if the patient is switched to an antipsychotic with a different profile or if adjunctive treatment with serotonin reuptake inhibitors (SSRIs) is undergone. Regarding OC schizophrenia, SSRIs are often a necessary part of treatment, with knowledge of potential pharmacokinetic interactions with antipsychotic drugs essential. In th...Continue Reading

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Citations

Oct 17, 2015·Psychiatry Research·Matteo TonnaCarlo Marchesi
May 25, 2016·The Psychiatric Clinics of North America·Sun Young YumLewis A Opler
Oct 21, 2015·Case Reports in Psychiatry·Ahmad Nabil Md Rosli, Wan Salwina Wan Ismail
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Oct 27, 2020·Case Reports in Psychiatry·Hsinsung Yuan, Junjun Liu
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