Top

Published in:

01-11-2014 | Genetic Disorders (W Berrettini, Section Editor)

Second Generation Antipsychotic-Induced Obsessive-Compulsive Symptoms in Schizophrenia: A Review of the Experimental Literature

Authors: Trehani M. Fonseka, Margaret A. Richter, Daniel J. Müller

Published in: Current Psychiatry Reports | Issue 11/2014

Abstract

Second generation antipsychotics (SGAs) have been implicated in the de novo emergence and exacerbation of obsessive-compulsive symptoms (OCS) in patients with schizophrenia. Among SGAs, clozapine, olanzapine, and risperidone are the most prominent agents associated with these sequelae, according to case reports. Comorbid OCS can impede recovery by compromising treatment benefits, medication compliance, and clinical prognoses. Previous reviews of SGA-induced OCS have predominantly focused on descriptive case reports, with limited attention paid toward experimental findings. To address this paucity of data, we sought to review the effects of SGAs on OCS in schizophrenia in the experimental literature, while addressing the role of different treatment (duration, dose, serum levels) and pharmacogenetic factors. Our findings suggest that clozapine confers the greatest risk of OCS in schizophrenia, with 20 to 28 % of clozapine-treated patients experiencing de novo OCS, in addition to 10 to 18 % incurring an exacerbation of pre-existing OCS. Clozapine can also yield full threshold obsessive-compulsive disorder (OCD), in some cases. Olanzapine is another high risk drug for secondary OCS which occurs in 11 to 20 % of schizophrenic patients receiving olanzapine therapy. At this time, there is insufficient experimental evidence to characterize the effects of other SGAs on OCS. Despite some experimental support for the involvement of longer treatment duration and genetic factors in mediating drug-induced OCS, more research is needed to clearly elucidate these associations. Based on these results, schizophrenic patients should be routinely monitored for OCS throughout the course of SGA treatment, particularly when clozapine or olanzapine is administered.

Mura G, Petretto DR, Bhat KM, Carta MG. Schizophrenia: from epidemiology to rehabilitation. Clin Pract Epidemiol Ment Health CP EMH. 2012;8:52–66. doi:10.2174/1745017901208010052.

Jablensky A. Epidemiology of schizophrenia: the global burden of disease and disability. Eur Arch Psychiatry Clin Neurosci. 2000;250(6):274–85.PubMed

Bhugra D. The global prevalence of schizophrenia. PLoS Med. 2005;2(5):e151. doi:10.1371/journal.pmed.0020151. quiz e75.PubMedPubMedCentral

Lykouras L, Alevizos B, Michalopoulou P, Rabavilas A. Obsessive-compulsive symptoms induced by atypical antipsychotics. A review of the reported cases. Prog Neuro-Psychopharmacol Biol Psychiatry. 2003;27(3):333–46. doi:10.1016/S0278-5846(03)00039-3.

Kim JH, Ryu S, Nam HJ, Lim M, Baek JH, Joo YH, et al. Symptom structure of antipsychotic-induced obsessive compulsive symptoms in schizophrenia patients. Prog Neuro-Psychopharmacol Biol Psychiatry. 2012;39(1):75–9. doi:10.1016/j.pnpbp.2012.05.011.

Kruger S, Braunig P, Hoffler J, Shugar G, Borner I, Langkrar J. Prevalence of obsessive-compulsive disorder in schizophrenia and significance of motor symptoms. J Neuropsychiatry Clin Neurosci. 2000;12(1):16–24.PubMed

Eisen JL, Beer DA, Pato MT, Venditto TA, Rasmussen SA. Obsessive-compulsive disorder in patients with schizophrenia or schizoaffective disorder. Am J Psychiatry. 1997;154(2):271–3.PubMed

Owashi T, Ota A, Otsubo T, Susa Y, Kamijima K. Obsessive-compulsive disorder and obsessive-compulsive symptoms in Japanese inpatients with chronic schizophrenia - a possible schizophrenic subtype. Psychiatry Res. 2010;179(3):241–6. doi:10.1016/j.psychres.2009.08.003.PubMed

Kayahan B, Ozturk O, Veznedaroglu B, Eraslan D. Obsessive-compulsive symptoms in schizophrenia: prevalance and clinical correlates. Psychiatry Clin Neurosci. 2005;59(3):291–5. doi:10.1111/j.1440-1819.2005.01373.x.PubMed

10.

Nechmad A, Ratzoni G, Poyurovsky M, Meged S, Avidan G, Fuchs C, et al. Obsessive-compulsive disorder in adolescent schizophrenia patients. Am J Psychiatry. 2003;160(5):1002–4.PubMed

11.

Poyurovsky M, Hramenkov S, Isakov V, Rauchverger B, Modai I, Schneidman M, et al. Obsessive-compulsive disorder in hospitalized patients with chronic schizophrenia. Psychiatry Res. 2001;102(1):49–57.PubMed

12.

Tibbo P, Kroetsch M, Chue P, Warneke L. Obsessive-compulsive disorder in schizophrenia. J Psychiatr Res. 2000;34(2):139–46.PubMed

13.

Jaydeokar S, Gore Y, Diwan P, Deshpande P, Desai N. Obsessive-compulsive symptoms in chronic schizophrenia: a new idea or an old belief? Indian J Psychiatry. 1997;39(4):324–8.PubMedPubMedCentral

14.

Berman I, Kalinowski A, Berman SM, Lengua J, Green AI. Obsessive and compulsive symptoms in chronic schizophrenia. Compr Psychiatry. 1995;36(1):6–10.PubMed

15.

Achim AM, Maziade M, Raymond E, Olivier D, Merette C, Roy MA. How prevalent are anxiety disorders in schizophrenia? A meta-analysis and critical review on a significant association. Schizophr Bull. 2011;37(4):811–21. doi:10.1093/schbul/sbp148.PubMedPubMedCentral

16.•

Swets M, Dekker J, van Emmerik-van Oortmerssen K, Smid GE, Smit F, de Haan L, et al. The obsessive compulsive spectrum in schizophrenia, a meta-analysis and meta-regression exploring prevalence rates. Schizophr Res. 2014;152(2-3):458–68. doi:10.1016/j.schres.2013.10.033. A comprehensive up-to-date meta-analysis and meta-regression of 43 studies that identified adjusted mean rates of 13.6 % for OCD and 30.3 % for OCS in patients with schizophrenia.PubMed

17.

Fullana MA, Mataix-Cols D, Caspi A, Harrington H, Grisham JR, Moffitt TE, et al. Obsessions and compulsions in the community: prevalence, interference, help-seeking, developmental stability, and co-occurring psychiatric conditions. Am J Psychiatry. 2009;166(3):329–36. doi:10.1176/appi.ajp.2008.08071006.PubMed

18.

El-Sayegh S, Bea S, Agelopoulos A. Obsessive-compulsive disorder: unearthing a hidden problem. Cleve Clin J Med. 2003;70(10):824–5. 9-30, 32-3, passim.PubMed

19.

Fireman B, Koran LM, Leventhal JL, Jacobson A. The prevalence of clinically recognized obsessive-compulsive disorder in a large health maintenance organization. Am J Psychiatry. 2001;158(11):1904–10.PubMed

20.

Stein MB, Forde DR, Anderson G, Walker JR. Obsessive-compulsive disorder in the community: an epidemiologic survey with clinical reappraisal. Am J Psychiatry. 1997;154(8):1120–6.PubMed

21.

Karno M, Golding JM, Sorenson SB, Burnam MA. The epidemiology of obsessive-compulsive disorder in five US communities. Arch Gen Psychiatry. 1988;45(12):1094–9.PubMed

22.

Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):53–63. doi:10.1038/mp.2008.94.PubMedPubMedCentral

23.

Cavallaro R, Cavedini P, Mistretta P, Bassi T, Angelone SM, Ubbiali A, et al. Basal-corticofrontal circuits in schizophrenia and obsessive-compulsive disorder: a controlled, double dissociation study. Biol Psychiatry. 2003;54(4):437–43.PubMed

24.

Abbruzzese M, Bellodi L, Ferri S, Scarone S. Frontal lobe dysfunction in schizophrenia and obsessive-compulsive disorder: a neuropsychological study. Brain Cogn. 1995;27(2):202–12. doi:10.1006/brcg.1995.1017.PubMed

25.

Tibbo P, Warneke L. Obsessive-compulsive disorder in schizophrenia: epidemiologic and biologic overlap. J Psychiatry Neurosci JPN. 1999;24(1):15–24.

26.

de Haan L, Dudek-Hodge C, Verhoeven Y, Denys D. Prevalence of psychotic disorders in patients with obsessive-compulsive disorder. CNS Spectrums. 2009;14(8):415–7.PubMed

27.

Eisen JL, Rasmussen SA. Obsessive compulsive disorder with psychotic features. J Clin Psychiatry. 1993;54(10):373–9.PubMed

28.

Sterk B, Lankreijer K, Linszen DH, de Haan L. Obsessive–compulsive symptoms in first episode psychosis and in subjects at ultra high risk for developing psychosis; onset and relationship to psychotic symptoms. Aust N Z J Psychiatry. 2011;45(5):400–6. doi:10.3109/00048674.2010.533363.PubMed

29.

Shioiri T, Shinada K, Kuwabara H, Someya T. Early prodromal symptoms and diagnoses before first psychotic episode in 219 inpatients with schizophrenia. Psychiatry Clin Neurosci. 2007;61(4):348–54. doi:10.1111/j.1440-1819.2007.01685.x.PubMed

30.

Veale D, Roberts A. Obsessive-compulsive disorder. BMJ. 2014;348:g2183. doi:10.1136/bmj.g2183.PubMed

31.

Heyman I, Mataix-Cols D, Fineberg NA. Obsessive-compulsive disorder. BMJ. 2006;333(7565):424–9. doi:10.1136/bmj.333.7565.424.PubMedPubMedCentral

32.

Stein DJ. Obsessive-compulsive disorder. Lancet. 2002;360(9330):397–405. doi:10.1016/S0140-6736(02)09620-4.PubMed

33.

Bokor G, Anderson PD. Obsessive-compulsive disorder. J Pharm Pract. 2014;27(2):116–30. doi:10.1177/0897190014521996.PubMed

34.

Thomsen PH. Obsessive-compulsive disorders. Eur Child Adolesc Psychiatry. 2013;22 Suppl 1:S23–8. doi:10.1007/s00787-012-0357-7.PubMed

35.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.

36.

So SH, Freeman D, Dunn G, Kapur S, Kuipers E, Bebbington P, et al. Jumping to conclusions, a lack of belief flexibility and delusional conviction in psychosis: a longitudinal investigation of the structure, frequency, and relatedness of reasoning biases. J Abnorm Psychol. 2012;121(1):129–39. doi:10.1037/a0025297.PubMedPubMedCentral

37.

Garety PA, Freeman D, Jolley S, Dunn G, Bebbington PE, Fowler DG, et al. Reasoning, emotions, and delusional conviction in psychosis. J Abnorm Psychol. 2005;114(3):373–84. doi:10.1037/0021-843X.114.3.373.PubMed

38.

Appelbaum PS, Robbins PC, Vesselinov R. Persistence and stability of delusions over time. Compr Psychiatry. 2004;45(5):317–24. doi:10.1016/j.comppsych.2004.06.001.PubMed

39.

Appelbaum PS, Robbins PC, Roth LH. Dimensional approach to delusions: comparison across types and diagnoses. Am J Psychiatry. 1999;156(12):1938–43.PubMed

40.

Gold I, Hohwy J. Rationality and schizophrenic delusion. Mind Lang. 2000;15(1):146–67.

41.

Bottas A, Cooke RG, Richter MA. Comorbidity and pathophysiology of obsessive-compulsive disorder in schizophrenia: is there evidence for a schizo-obsessive subtype of schizophrenia? J Psychiatry Neurosci JPN. 2005;30(3):187–93.

42.

Eisen JLP, Katherine A, Rasmussen SA. Obsessions and delusions: the relationship between obsessive-compulsive disorder and the psychotic disorders. Psychiatr Ann. 1999;29(9):515–22.

43.

Tumkaya S, Karadag F, Oguzhanoglu NK, Tekkanat C, Varma G, Ozdel O, et al. Schizophrenia with obsessive-compulsive disorder and obsessive-compulsive disorder with poor insight: a neuropsychological comparison. Psychiatry Res. 2009;165(1–2):38–46. doi:10.1016/j.psychres.2007.07.031.PubMed

44.

Matsunaga H, Kiriike N, Matsui T, Oya K, Iwasaki Y, Koshimune K, et al. Obsessive-compulsive disorder with poor insight. Compr Psychiatry. 2002;43(2):150–7.PubMed

45.

Cunill R, Castells X. Schizo-obsessive disorder. In: Ritsner MS, editor. Handbook of schizophrenia spectrum disorders: phenotypic and endophenotypic presentations. Dordrecht: Springer; 2011.

46.

Guillem F, Satterthwaite J, Pampoulova T, Stip E. Relationship between psychotic and obsessive compulsive symptoms in schizophrenia. Schizophr Res. 2009;115(2–3):358–62. doi:10.1016/j.schres.2009.06.004.PubMed

47.

Poyurovsky M, Fuchs C, Weizman A. Obsessive-compulsive disorder in patients with first-episode schizophrenia. Am J Psychiatry. 1999;156(12):1998–2000.PubMed

48.

Sa AR, Hounie AG, Sampaio AS, Arrais J, Miguel EC, Elkis H. Obsessive-compulsive symptoms and disorder in patients with schizophrenia treated with clozapine or haloperidol. Compr Psychiatry. 2009;50(5):437–42. doi:10.1016/j.comppsych.2008.11.005.PubMed

49.

Tiryaki A, Ozkorumak E. Do the obsessive-compulsive symptoms have an effect in schizophrenia? Compr Psychiatry. 2010;51(4):357–62. doi:10.1016/j.comppsych.2009.10.007.PubMed

50.

Ongur D, Goff DC. Obsessive-compulsive symptoms in schizophrenia: associated clinical features, cognitive function and medication status. Schizophr Res. 2005;75(2–3):349–62. doi:10.1016/j.schres.2004.08.012.PubMed

51.

Lysaker PH, Marks KA, Picone JB, Rollins AL, Fastenau PS, Bond GR. Obsessive and compulsive symptoms in schizophrenia: clinical and neurocognitive correlates. J Nerv Ment Dis. 2000;188(2):78–83.PubMed

52.

Hwang MY, Morgan JE, Losconzcy MF. Clinical and neuropsychological profiles of obsessive-compulsive schizophrenia: a pilot study. J Neuropsychiatry Clin Neurosci. 2000;12(1):91–4.PubMed

53.

Scheltema Beduin AA, Swets M, Machielsen M, Korver N. Obsessive-compulsive symptoms in patients with schizophrenia: a naturalistic cross-sectional study comparing treatment with clozapine, olanzapine, risperidone, and no antipsychotics in 543 patients. J Clin Psychiatry. 2012;73(11):1395–402. doi:10.4088/JCP.11m07164.PubMed

54.

Mukhopadhaya K, Krishnaiah R, Taye T, Nigam A, Bailey AJ, Sivakumaran T, et al. Obsessive-compulsive disorder in UK clozapine-treated schizophrenia and schizoaffective disorder: a cause for clinical concern. J Psychopharmacol. 2009;23(1):6–13. doi:10.1177/0269881108089582.PubMed

55.

Lysaker PH, Bryson GJ, Marks KA, Greig TC, Bell MD. Association of obsessions and compulsions in schizophrenia with neurocognition and negative symptoms. J Neuropsychiatry Clin Neurosci. 2002;14(4):449–53.PubMed

56.

Berman I, Merson A, Viegner B, Losonczy MF, Pappas D, Green AI. Obsessions and compulsions as a distinct cluster of symptoms in schizophrenia: a neuropsychological study. J Nerv Ment Dis. 1998;186(3):150–6.PubMed

57.

Schirmbeck F, Esslinger C, Rausch F, Englisch S, Meyer-Lindenberg A, Zink M. Antiserotonergic antipsychotics are associated with obsessive-compulsive symptoms in schizophrenia. Psychol Med. 2011;41(11):2361–73. doi:10.1017/S0033291711000419.PubMed

58.

Rajkumar RP, Reddy YC, Kandavel T. Clinical profile of "schizo-obsessive" disorder: a comparative study. Compr Psychiatry. 2008;49(3):262–8. doi:10.1016/j.comppsych.2007.09.006.PubMed

59.

Poyurovsky M, Faragian S, Shabeta A, Kosov A. Comparison of clinical characteristics, co-morbidity and pharmacotherapy in adolescent schizophrenia patients with and without obsessive-compulsive disorder. Psychiatry Res. 2008;159(1–2):133–9. doi:10.1016/j.psychres.2007.06.010.PubMed

60.

Poyurovsky M, Fuchs C, Faragian S, Kriss V, Weisman G, Pashinian A, et al. Preferential aggregation of obsessive-compulsive spectrum disorders in schizophrenia patients with obsessive-compulsive disorder. Can J Psychiatry. 2006;51(12):746–54.PubMed

61.

Hagen K, Hansen B, Joa I, Larsen TK. Prevalence and clinical characteristics of patients with obsessive-compulsive disorder in first-episode psychosis. BMC Psychiatry. 2013;13:156. doi:10.1186/1471-244X-13-156.PubMedPubMedCentral

62.

Sevincok L, Akoglu A, Kokcu F. Suicidality in schizophrenic patients with and without obsessive-compulsive disorder. Schizophr Res. 2007;90(1–3):198–202. doi:10.1016/j.schres.2006.09.023.PubMed

63.

de Haan L, Sterk B, Wouters L, Linszen DH. The 5-year course of obsessive-compulsive symptoms and obsessive-compulsive disorder in first-episode schizophrenia and related disorders. Schizophr Bull. 2013;39(1):151–60. doi:10.1093/schbul/sbr077.PubMedPubMedCentral

64.

Ke CL, Yen CF, Chen CC, Yang SJ, Chung W, Yang MJ. Obsessive-compulsive symptoms associated with clozapine and risperidone treatment: three case reports and review of the literature. Kaohsiung J Med Sci. 2004;20(6):295–301. doi:10.1016/S1607-551X(09)70121-4.PubMed

65.•

Cai J, Zhang W, Yi Z, Lu W, Wu Z, Chen J, et al. Influence of polymorphisms in genes SLC1A1, GRIN2B, and GRIK2 on clozapine-induced obsessive-compulsive symptoms. Psychopharmacology. 2013;230(1):49–55. doi:10.1007/s00213-013-3137-2. In this genetic study, SLC1A1 and GRIN2B variants were found to increase risk and severity of OCS among schizophrenia patients treated with clozapine, an antiserotonergic antipsychotic most strongly implicated in treatment-emergent OCS.PubMed

66.

Ripke S, O'Dushlaine C, Chambert K, Moran JL, Kahler AK, Akterin S, et al. Genome-wide association analysis identifies 13 new risk loci for schizophrenia. Nat Genet. 2013;45(10):1150–9. doi:10.1038/ng.2742.PubMed

67.

Cardno AG, Marshall EJ, Coid B, Macdonald AM, Ribchester TR, Davies NJ, et al. Heritability estimates for psychotic disorders: the Maudsley twin psychosis series. Arch Gen Psychiatry. 1999;56(2):162–8.PubMed

68.

Pauls DL, Abramovitch A, Rauch SL, Geller DA. Obsessive-compulsive disorder: an integrative genetic and neurobiological perspective. Nat Rev Neurosci. 2014;15(6):410–24. doi:10.1038/nrn3746.PubMed

69.

Nicolini H, Arnold P, Nestadt G, Lanzagorta N, Kennedy JL. Overview of genetics and obsessive-compulsive disorder. Psychiatry Res. 2009;170(1):7–14. doi:10.1016/j.psychres.2008.10.011.PubMed

70.

Ryu S, Oh S, Cho EY, Nam HJ, Yoo JH, Park T, et al. Interaction between genetic variants of DLGAP3 and SLC1A1 affecting the risk of atypical antipsychotics-induced obsessive-compulsive symptoms. Am J Med Genet B Neuropsychiatr Genet Off Publ Int Soc Psychiatr Genet. 2011;156B(8):949–59. doi:10.1002/ajmg.b.31242.

71.

Kwon JS, Joo YH, Nam HJ, Lim M, Cho EY, Jung MH, et al. Association of the glutamate transporter gene SLC1A1 with atypical antipsychotics-induced obsessive-compulsive symptoms. Arch Gen Psychiatry. 2009;66(11):1233–41. doi:10.1001/archgenpsychiatry.2009.155.PubMed

72.•

Schirmbeck F, Nieratschker V, Frank J, Englisch S, Rausch F, Meyer-Lindenberg A, et al. Polymorphisms in the glutamate transporter gene SLC1A1 and obsessive-compulsive symptoms induced by second-generation antipsychotic agents. Psychiatr Genet. 2012;22(5):245–52. doi:10.1097/YPG.0b013e328353fbee. A replication study of Kwon et al. (2009)[67] performed among Europeans. This study did not find a genetic association between SLC1A1 and OCS, in contrast to the original study tested in an Asian sample. Findings provide support for ethnicity as a mediating factor for SLC1A1 effects on OCS.PubMed

73.

Aouizerate B, Guehl D, Cuny E, Rougier A, Burbaud P, Tignol J, et al. Updated overview of the putative role of the serotoninergic system in obsessive-compulsive disorder. Neuropsychiatr Dis Treat. 2005;1(3):231–43.PubMedPubMedCentral

74.

Charney DS, Goodman WK, Price LH, Woods SW, Rasmussen SA, Heninger GR. Serotonin function in obsessive-compulsive disorder. A comparison of the effects of tryptophan and m-chlorophenylpiperazine in patients and healthy subjects. Arch Gen Psychiatry. 1988;45(2):177–85.PubMed

75.

Pogarell O, Hamann C, Pöpperl G, Juckel G, Choukèr M, Zaudig M, et al. Elevated brain serotonin transporter availability in patients with obsessive-compulsive disorder. Biol Psychiatry. 2003;54(12):1406–13. doi:10.1016/s0006-3223(03)00183-5.PubMed

76.

Barr LC, Goodman WK, Price LH. The serotonin hypothesis of obsessive compulsive disorder. Int Clin Psychopharmacol. 1993;8 Suppl 2:79–82.PubMed

77.

Billett EA, Richter MA, King N, Heils A, Lesch KP, Kennedy JL. Obsessive compulsive disorder, response to serotonin reuptake inhibitors and the serotonin transporter gene. Mol Psychiatry. 1997;2(5):403–6.PubMed

78.

Hanna GL, Himle JA, Curtis GC, Koram DQ, Veenstra-VanderWeele J, Leventhal BL, et al. Serotonin transporter and seasonal variation in blood serotonin in families with obsessive-compulsive disorder. Neuropsychopharmacol Off Publ Am Coll Neuropsychopharmacol. 1998;18(2):102–11. doi:10.1016/S0893-133X(97)00097-3.

79.

Zohar J, Mueller EA, Insel TR, Zohar-Kadouch RC, Murphy DL. Serotonergic responsivity in obsessive-compulsive disorder. Comparison of patients and healthy controls. Arch Gen Psychiatry. 1987;44(11):946–51.PubMed

80.

Hanna GL, Yuwiler A, Cantwell DP. Whole blood serotonin during clomipramine treatment of juvenile obsessive-compulsive disorder. J Child Adolesc Psychopharmacol. 1993;3(4):223–9.

81.

Koo MS, Kim EJ, Roh D, Kim CH. Role of dopamine in the pathophysiology and treatment of obsessive-compulsive disorder. Expert Rev Neurother. 2010;10(2):275–90. doi:10.1586/ern.09.148.PubMed

82.

Goodman WK, McDougle CJ, Price LH, Riddle MA, Pauls DL, Leckman JF. Beyond the serotonin hypothesis: a role for dopamine in some forms of obsessive compulsive disorder? J Clin Psychiatry. 1990;51(Suppl):36–43. discussion 55-8.PubMed

83.

Pittenger C, Bloch MH, Williams K. Glutamate abnormalities in obsessive compulsive disorder: neurobiology, pathophysiology, and treatment. Pharmacol Ther. 2011;132(3):314–32. doi:10.1016/j.pharmthera.2011.09.006.PubMedPubMedCentral

84.

Stahl SM. Antipsychotic Agents. Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 3rd ed. New York: Cambridge University Press; 2008.

85.

Kapur S, Zipursky RB, Remington G. Clinical and theoretical implications of 5-HT2 and D2 receptor occupancy of clozapine, risperidone, and olanzapine in schizophrenia. Am J Psychiatry. 1999;156(2):286–93.PubMed

86.

Meltzer HY, Huang M. In vivo actions of atypical antipsychotic drug on serotonergic and dopaminergic systems. Prog Brain Res. 2008;172:177–97. doi:10.1016/S0079-6123(08)00909-6.PubMed

87.

Mamo D, Kapur S, Shammi CM, Papatheodorou G, Mann S, Therrien F, et al. A PET study of dopamine D2 and serotonin 5-HT2 receptor occupancy in patients with schizophrenia treated with therapeutic doses of ziprasidone. Am J Psychiatry. 2004;161(5):818–25.PubMed

88.

Kapur S, Zipursky R, Jones C, Shammi CS, Remington G, Seeman P. A positron emission tomography study of quetiapine in schizophrenia: a preliminary finding of an antipsychotic effect with only transiently high dopamine D2 receptor occupancy. Arch Gen Psychiatry. 2000;57(6):553–9.PubMed

89.

Mamo D, Graff A, Mizrahi R, Shammi CM, Romeyer F, Kapur S. Differential effects of aripiprazole on D(2), 5-HT(2), and 5-HT(1A) receptor occupancy in patients with schizophrenia: a triple tracer PET study. Am J Psychiatry. 2007;164(9):1411–7. doi:10.1176/appi.ajp.2007.06091479.PubMed

90.

Kapur S, Zipursky RB, Remington G, Jones C, DaSilva J, Wilson AA, et al. 5-HT2 and D2 receptor occupancy of olanzapine in schizophrenia: a PET investigation. Am J Psychiatry. 1998;155(7):921–8.PubMed

91.

Nyberg S, Eriksson B, Oxenstierna G, Halldin C, Farde L. Suggested minimal effective dose of risperidone based on PET-measured D2 and 5-HT2A receptor occupancy in schizophrenic patients. Am J Psychiatry. 1999;156(6):869–75.PubMed

92.

Stahl SM. Describing an atypical antipsychotic: receptor binding and its role in pathophysiology. Prim Care Companion J Clin Psychiatry. 2003;5 suppl 3:9–13.

93.

Kapur S, Seeman P. Does fast dissociation from the dopamine d(2) receptor explain the action of atypical antipsychotics?: a new hypothesis. Am J Psychiatr. 2001;158(3):360–9.PubMed

94.

Ma N, Tan LW, Wang Q, Li ZX, Li LJ. Lower levels of whole blood serotonin in obsessive-compulsive disorder and in schizophrenia with obsessive-compulsive symptoms. Psychiatry Res. 2007;150(1):61–9. doi:10.1016/j.psychres.2005.10.005.PubMed

95.

McDougle CJ, Goodman WK, Leckman JF, Lee NC, Heninger GR, Price LH. Haloperidol addition in fluvoxamine-refractory obsessive-compulsive disorder. A double-blind, placebo-controlled study in patients with and without tics. Arch Gen Psychiatry. 1994;51(4):302–8.PubMed

96.

O'Regan JB. Treatment of obsessive–compulsive neurosis with haloperidol. Can Med Assoc J. 1970;103(2):167–8.PubMedPubMedCentral

97.

Kim SW, Shin IS, Kim JM, Yang SJ, Hwang MY, Yoon JS. Amisulpride improves obsessive-compulsive symptoms in schizophrenia patients taking atypical antipsychotics: an open-label switch study. J Clin Psychopharmacol. 2008;28(3):349–52. doi:10.1097/JCP.0b013e318172755a.PubMed

98.

Yang KC, Su TP, Chou YH. Effectiveness of aripiprazole in treating obsessive compulsive symptoms. Prog Neuro-Psychopharmacol Biol Psychiatry. 2008;32(2):585–6. doi:10.1016/j.pnpbp.2007.10.009.

99.

Connor KM, Payne VM, Gadde KM, Zhang W, Davidson JR. The use of aripiprazole in obsessive-compulsive disorder: preliminary observations in 8 patients. J Clin Psychiatry. 2005;66(1):49–51.PubMed

100.

Eryilmaz G, Hizli Sayar G, Ozten E, Gogcegoz Gul I, Karamustafalioglu O. Aripirazole augmentation in clozapine-associated obsessive-compulsive symptoms in schizophrenia. Ann Gen Psychiatry. 2013;12(1):40. doi:10.1186/1744-859X-12-40.PubMedPubMedCentral

101.

Skapinakis P, Papatheodorou T, Mavreas V. Antipsychotic augmentation of serotonergic antidepressants in treatment-resistant obsessive-compulsive disorder: a meta-analysis of the randomized controlled trials. Eur Neuropsychopharmacol J Eur Coll Neuropsychopharmacol. 2007;17(2):79–93. doi:10.1016/j.euroneuro.2006.07.002.

102.

Dold M, Aigner M, Lanzenberger R, Kasper S. Antipsychotic augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder: a meta-analysis of double-blind, randomized, placebo-controlled trials. Int J Neuropsychopharmacol. 2013;16(3):557–74. doi:10.1017/S1461145712000740.PubMed

103.

Sareen J, Kirshner A, Lander M, Kjernisted KD, Eleff MK, Reiss JP. Do antipsychotics ameliorate or exacerbate obsessive compulsive disorder symptoms? a systematic review. J Affect Disord. 2004;82(2):167–74. doi:10.1016/j.jad.2004.03.011.PubMed

104.

Tibbo P, Gendemann K. Improvement of obsessions and compulsions with clozapine in an individual with schizophrenia. Can J Psychiatry. 1999;44(10):1049–50.PubMed

105.

Poyurovsky M, Dorfman-Etrog P, Hermesh H, Munitz H, Tollefson GD, Weizman A. Beneficial effect of olanzapine in schizophrenic patients with obsessive-compulsive symptoms. Int Clin Psychopharmacol. 2000;15(3):169–73.PubMed

106.

Biondi M, Fedele L, Arcangeli T, Pancheri P. Development of obsessive-compulsive symptoms during clozapine treatment in schizophrenia and its positive response to clomipramine. Psychother Psychosom. 1999;68(2):111–2.PubMed

107.

Eales MJ, Layeni AO. Exacerbation of obsessive-compulsive symptoms associated with clozapine. Br J Psychiatry J Ment Sci. 1994;164(5):687–8.

108.

Allen L, Tejera C. Treatment of clozapine-induced obsessive-compulsive symptoms with sertraline. Am J Psychiatry. 1994;151(7):1096–7.PubMed

109.

Cheung EF. Obsessive-compulsive symptoms during treatment with clozapine in a patient with schizophrenia. Aust N Z J Psychiatr. 2001;35(5):695–6.

110.

Englisch S, Esslinger C, Inta D, Weinbrenner A, Peus V, Gutschalk A, et al. Clozapine-induced obsessive-compulsive syndromes improve in combination with aripiprazole. Clin Neuropharmacol. 2009;32(4):227–9. doi:10.1097/WNF.0b013e31819cc8e6.PubMed

111.

Levkovitch Y, Kronnenberg Y, Gaoni B. Can clozapine trigger OCD? J Am Acad Child Adolesc Psychiatry. 1995;34(3):263. doi:10.1097/00004583-199503000-00005.PubMed

112.

Baker RW, Chengappa KN, Baird JW, Steingard S, Christ MA, Schooler NR. Emergence of obsessive compulsive symptoms during treatment with clozapine. J Clin Psychiatry. 1992;53(12):439–42.PubMed

113.

de Haan L, Linszen DH, Gorsira R. Clozapine and obsessions in patients with recent-onset schizophrenia and other psychotic disorders. J Clin Psychiatry. 1999;60(6):364–5.PubMed

114.

Ghaemi SN, Zarate Jr CA, Popli AP, Pillay SS, Cole JO. Is there a relationship between clozapine and obsessive-compulsive disorder?: a retrospective chart review. Compr Psychiatry. 1995;36(4):267–70.PubMed

115.

De Haan L, Oekeneva A, Van Amelsvoort T, Linszen D. Obsessive-compulsive disorder and treatment with clozapine in 200 patients with recent-onset schizophrenia or related disorders. Eur Psychiatry J Assoc Eur Psychiatr. 2004;19(8):524. doi:10.1016/j.eurpsy.2004.09.022.

116.

Coskun M, Zoroglu S. Clozapine induced obsessions treated with sertraline in an adolescent with schizophrenia. Bull Clin Psychopharmacol. 2009;19:155–8.

117.

Zink M, Englisch S, Knopf U, Kuwilsky A, Dressing H. Augmentation of clozapine with valproic acid for clozapine-induced obsessive-compulsive symptoms. Pharmacopsychiatry. 2007;40(5):202–3. doi:10.1055/s-2007-985885.PubMed

118.

Canan F, Aydinoglu U, Sinani G. Valproic acid augmentation in clozapine-associated hand-washing compulsion. Psychiatry Clin Neurosci. 2012;66(5):463–4. doi:10.1111/j.1440-1819.2012.02361.x.PubMed

119.

Aggarwal A, Sharma D, Sharma R, Kumar R. Obsessive-compulsive symptoms following clozapine administration. Prim Psychiatry. 2010;17(3):58–9.

120.

Poyurovsky M, Hermesh H, Weizman A. Fluvoxamine treatment in clozapine-induced obsessive-compulsive symptoms in schizophrenic patients. Clin Neuropharmacol. 1996;19(4):305–13.PubMed

121.

Reznik I, Sirota P. Obsessive and compulsive symptoms in schizophrenia: a randomized controlled trial with fluvoxamine and neuroleptics. J Clin Psychopharmacol. 2000;20(4):410–6.PubMed

122.

Rahman MS, Grace JJ, Pato MT, Priest B. Sertraline in the treatment of clozapine-induced obsessive-compulsive behavior. Am J Psychiatry. 1998;155(11):1629–30.PubMed

123.

Rao NP, Antony A, Raveendranathan D, Venkatasubramanian G, Behere RV, Varambally SS, et al. Successful use of maintenance electroconvulsive therapy in the treatment of clozapine-associated obsessive-compulsive symptoms in schizophrenia: a case report. J ECT. 2011;27(1):e37–8. doi:10.1097/YCT.0b013e3181ec0d64.PubMed

124.

Kumar S, Ng B, Howie W. The improvement of obsessive- compulsive symptoms in a patient with schizophrenia treated with clozapine. Psychiatry Clin Neurosci. 2003;57(2):235–6. doi:10.1046/j.1440-1819.2003.01107.x.PubMed

125.

Poyurovsky M, Bergman Y, Shoshani D, Schneidman M, Weizman A. Emergence of obsessive–compulsive symptoms and tics during clozapine withdrawal. Clin Neuropharmacol. 1998;21(2):97–100.PubMed

126.

Lin SK, Su SF, Pan CH. Higher plasma drug concentration in clozapine-treated schizophrenic patients with side effects of obsessive/compulsive symptoms. Ther Drug Monit. 2006;28(3):303–7. doi:10.1097/01.ftd.0000211801.66569.80.PubMed

127.

Ertugrul A, Anil Yagcioglu AE, Eni N, Yazici KM. Obsessive-compulsive symptoms in clozapine-treated schizophrenic patients. Psychiatry Clin Neurosci. 2005;59(2):219–22. doi:10.1111/j.1440-1819.2005.01362.x.PubMed

128.

Lim M, Park DY, Kwon JS, Joo YH, Hong KS. Prevalence and clinical characteristics of obsessive-compulsive symptoms associated with atypical antipsychotics. J Clin Psychopharmacol. 2007;27(6):712–3. doi:10.1097/JCP.0b013e31815a584c.PubMed

129.

Mahendran R, Liew E, Subramaniam M. De novo emergence of obsessive-compulsive symptoms with atypical antipsychotics in asian patients with schizophrenia or schizoaffective disorder: a retrospective, cross-sectional study. J Clin Psychiatry. 2007;68(4):542–5.PubMed

130.•

Doyle M, Chorcorain AN, Griffith E, Trimble T, O'Callaghan E. Obsessive compulsive symptoms in patients with Schizophrenia on clozapine and with obsessive compulsive disorder: a comparison study. Compr Psychiatry. 2014;55(1):130–6. doi:10.1016/j.comppsych.2013.09.001. A comparison study which found that treatment-induced OCS was characterized by greater cognitive symptoms as compared to primary OCD where behaavioural symptoms predominate.PubMed

131.•

Schirmbeck F, Rausch F, Englisch S, Eifler S, Esslinger C, Meyer-Lindenberg A, et al. Differential effects of antipsychotic agents on obsessive-compulsive symptoms in schizophrenia: a longitudinal study. J Psychopharmacol. 2013;27(4):349–57. doi:10.1177/0269881112463470. A longitudinal study which assessed the long-term effects of antipsychotic treatment on OCS in schizophrenia. Results demonstrated persistently high OCS severity among patients treated with clozapine and olanzapine versus patients treated with either aripiprazole and amisuplride who showed OCS improvement over time.PubMed

132.

Grassi G, Poli L, Cantisani A, Righi L, Ferrari G, Pallanti S. Hypochondriasis and obsessive-compulsive disorder in schizophrenic patients treated with clozapine vs other atypical antipsychotics. CNS Spectrums. 2013;1:1–7. doi:10.1017/S1092852913000795.

133.

Alevizos B, Papageorgiou C, Christodoulou GN. Obsessive-compulsive symptoms with olanzapine. Int J Neuropsychopharmacol. 2004;7(3):375–7. doi:10.1017/S1461145704004456.PubMed

134.

Mahendran R. Emergence of compulsive symptoms with olanzapine treatment. Aust N Z J Psychiatr. 2002;36(4):565.

135.

Morrison D, Clark D, Goldfarb E, McCoy L. Worsening of obsessive-compulsive symptoms following treatment with olanzapine. Am J Psychiatry. 1998;155(6):855.PubMed

136.

Lykouras L, Zervas IM, Gournellis R, Malliori M, Rabavilas A. Olanzapine and obsessive-compulsive symptoms. Eur Neuropsychopharmacol J Eur Coll Neuropsychopharmacol. 2000;10(5):385–7.

137.

Kulkarni G, Narayanaswamy JC, Math SB. Olanzapine induced de-novo obsessive compulsive disorder in a patient with schizophrenia. Indian J Pharmacol. 2012;44(5):649–50. doi:10.4103/0253-7613.100406.PubMedPubMedCentral

138.

Mottard JP, De La Sablonniere JF. Olanzapine-induced obsessive-compulsive disorder. Am J Psychiatry. 1999;156(5):799–800.PubMed

139.

Francobandiera G. Olanzapine augmentation of serotonin uptake inhibitors in obsessive-compulsive disorder: an open study. Can J Psychiatry. 2001;46(4):356–8.PubMed

140.

Koran LM, Ringold AL, Elliott MA. Olanzapine augmentation for treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry. 2000;61(7):514–7.PubMed

141.

Weiss EL, Potenza MN, McDougle CJ, Epperson CN. Olanzapine addition in obsessive-compulsive disorder refractory to selective serotonin reuptake inhibitors: an open-label case series. J Clin Psychiatry. 1999;60(8):524–7.PubMed

142.

Potenza MN, Wasylink S, Longhurst JG, Epperson CN, McDougle CJ. Olanzapine augmentation of fluoxetine in the treatment of refractory obsessive-compulsive disorder. J Clin Psychopharmacol. 1998;18(5):423–4.PubMed

143.

de Haan L, Beuk N, Hoogenboom B, Dingemans P, Linszen D. Obsessive-compulsive symptoms during treatment with olanzapine and risperidone: a prospective study of 113 patients with recent-onset schizophrenia or related disorders. J Clin Psychiatry. 2002;63(2):104–7.PubMed

144.

van Nimwegen L, de Haan L, van Beveren N, Laan W, van den Brink W, Linszen D. Obsessive-compulsive symptoms in a randomized, double-blind study with olanzapine or risperidone in young patients with early psychosis. J Clin Psychopharmacol. 2008;28(2):214–8. doi:10.1097/JCP.0b013e318166f520.PubMed

145.

Baker RW, Ames D, Umbricht DS, Chengappa KN, Schooler NR. Obsessive-compulsive symptoms in schizophrenia: a comparison of olanzapine and placebo. Psychopharmacol Bull. 1996;32(1):89–93.PubMed

146.

Kopala L, Honer WG. Risperidone, serotonergic mechanisms, and obsessive-compulsive symptoms in schizophrenia. Am J Psychiatry. 1994;151(11):1714–5.PubMed

147.

Mahendran R. Obsessional symptoms associated with risperidone treatment. Aust N Z J Psychiatr. 1998;32(2):299–301.

148.

Alevizos B, Lykouras L, Zervas IM, Christodoulou GN. Risperidone-induced obsessive-compulsive symptoms: a series of six cases. J Clin Psychopharmacol. 2002;22(5):461–7.PubMed

149.

Bakaras P, Georgoussi M, Liakos A. Development of obsessive and depressive symptoms during risperidone treatment. Br J Psychiatry J Ment Sci. 1999;174:559.

150.

Dodt JE, Byerly MJ, Cuadros C, Christensen RC. Treatment of risperidone-induced obsessive-compulsive symptoms with sertraline. Am J Psychiatry. 1997;154(4):582.PubMed

151.

Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry. 2006;11(7):622–32. doi:10.1038/sj.mp.4001823.PubMed

152.

Saxena S, Wang D, Bystritsky A, Baxter Jr LR. Risperidone augmentation of SRI treatment for refractory obsessive-compulsive disorder. J Clin Psychiatry. 1996;57(7):303–6.PubMed

153.

Nguyen ML, Shapiro MA, Welch SJ. A case of severe adolescent obsessive-compulsive disorder treated with inpatient hospitalization, risperidone and sertraline. J Behav Addict. 2012;1(2):78–82.

154.

Veznedaroglu B, Ercan ES, Kayahan B, Varan A, Bayraktar E. Reduced short-term obsessive-compulsive symptoms in schizophrenic patients treated with risperidone: a single-blind prospective study. Hum Psychopharmacol. 2003;18(8):635–40. doi:10.1002/hup.536.PubMed

155.

Desarkar P, Das A, Nizamie SH. Aripiprazole-induced obsessive-compulsive disorder: a report of 2 cases. J Clin Psychopharmacol. 2007;27(3):305–6. doi:10.1097/01.jcp.0000270091.32286.0a.PubMed

156.

Schonfelder S, Schirmbeck F, Waltereit R, Englisch S, Zink M. Aripiprazole improves olanzapine-associated obsessive compulsive symptoms in schizophrenia. Clin Neuropharmacol. 2011;34(6):256–7. doi:10.1097/WNF.0b013e31823429bd.PubMed

157.

Glick ID, Poyurovsky M, Ivanova O, Koran LM. Aripiprazole in schizophrenia patients with comorbid obsessive-compulsive symptoms: an open-label study of 15 patients. J Clin Psychiatry. 2008;69(12):1856–9.PubMed

158.

Kim SW, Shin IS, Kim JM, Youn T, Yang SJ, Hwang MY, et al. The 5-HT2 receptor profiles of antipsychotics in the pathogenesis of obsessive-compulsive symptoms in schizophrenia. Clin Neuropharmacol. 2009;32(4):224–6. doi:10.1097/WNF.0b013e318184fafd.PubMed

159.

Khullar A, Chue P, Tibbo P. Quetiapine and obsessive-compulsive symptoms (OCS): case report and review of atypical antipsychotic-induced OCS. J Psychiatry Neurosci JPN. 2001;26(1):55–9.

160.

Stamouli S, Lykouras L. Quetiapine-induced obsessive-compulsive symptoms: a series of five cases. J Clin Psychopharmacol. 2006;26(4):396–400. doi:10.1097/01.jcp.0000227809.60664.6d.PubMed

161.

Tranulis C, Potvin S, Gourgue M, Leblanc G, Mancini-Marie A, Stip E. The paradox of quetiapine in obsessive-compulsive disorder. CNS Spectrums. 2005;10(5):356–61.PubMed

162.

Chen CH, Chiu CC, Huang MC. Dose-related exacerbation of obsessive-compulsive symptoms with quetiapine treatment. Prog Neuro-Psychopharmacol Biol Psychiatry. 2008;32(1):304–5. doi:10.1016/j.pnpbp.2007.07.024.

163.

Ozer S, Arsava M, Ertugrul A, Demir B. Obsessive compulsive symptoms associated with quetiapine treatment in a schizophrenic patient: a case report. Prog Neuro-Psychopharmacol Biol Psychiatry. 2006;30(4):724–7. doi:10.1016/j.pnpbp.2005.11.030.

164.

Denys D, de Geus F, van Megen HJ, Westenberg HG. A double-blind, randomized, placebo-controlled trial of quetiapine addition in patients with obsessive-compulsive disorder refractory to serotonin reuptake inhibitors. J Clin Psychiatry. 2004;65(8):1040–8.PubMed

165.

Bystritsky A, Ackerman DL, Rosen RM, Vapnik T, Gorbis E, Maidment KM, et al. Augmentation of serotonin reuptake inhibitors in refractory obsessive-compulsive disorder using adjunctive olanzapine: a placebo-controlled trial. J Clin Psychiatry. 2004;65(4):565–8.PubMed

166.

Kordon A, Wahl K, Koch N, Zurowski B, Anlauf M, Vielhaber K, et al. Quetiapine addition to serotonin reuptake inhibitors in patients with severe obsessive-compulsive disorder: a double-blind, randomized, placebo-controlled study. J Clin Psychopharmacol. 2008;28(5):550–4. doi:10.1097/JCP.0b013e318185e735.PubMed

167.

Carey PD, Vythilingum B, Seedat S, Muller JE, van Ameringen M, Stein DJ. Quetiapine augmentation of SRIs in treatment refractory obsessive-compulsive disorder: a double-blind, randomised, placebo-controlled study [ISRCTN83050762]. BMC Psychiatry. 2005;5:5. doi:10.1186/1471-244X-5-5.PubMedPubMedCentral

168.

Angelucci F, Ricci V, Martinotti G, Caltagirone C, Bria P. Paliperidone for treatment of obsessive compulsive resistant symptoms in schizophrenia: a case report. Prog Neuro-Psychopharmacol Biol Psychiatry. 2009;33(7):1277–8. doi:10.1016/j.pnpbp.2009.06.014.

169.

Toren P, Samuel E, Weizman R, Golomb A, Eldar S, Laor N. Case study: emergence of transient compulsive symptoms during treatment with clothiapine. J Am Acad Child Adolesc Psychiatry. 1995;34(11):1469–72.PubMed

170.

Komossa K, Depping AM, Meyer M, Kissling W, Leucht S. Second-generation antipsychotics for obsessive compulsive disorder. Cochrane Database Syst Rev. 2010;12, CD008141. doi:10.1002/14651858.CD008141.pub2.PubMed

171.

Reznik I, Sirota P. An open study of fluvoxamine augmentation of neuroleptics in schizophrenia with obsessive and compulsive symptoms. Clin Neuropharmacol. 2000;23(3):157–60.PubMed

172.

Poyurovsky M, Isakov V, Hromnikov S, Modai I, Rauchberger B, Schneidman M, et al. Fluvoxamine treatment of obsessive-compulsive symptoms in schizophrenic patients: an add-on open study. Int Clin Psychopharmacol. 1999;14(2):95–100.PubMed

173.

Meira-Lima I, Shavitt RG, Miguita K, Ikenaga E, Miguel EC, Vallada H. Association analysis of the catechol-o-methyltransferase (COMT), serotonin transporter (5-HTT) and serotonin 2A receptor (5HT2A) gene polymorphisms with obsessive-compulsive disorder. Genes Brain Behav. 2004;3(2):75–9.PubMed

174.

Enoch MA, Kaye WH, Rotondo A, Greenberg BD, Murphy DL, Goldman D. 5-HT2A promoter polymorphism -1438G/A, anorexia nervosa, and obsessive-compulsive disorder. Lancet. 1998;351(9118):1785–6. doi:10.1016/S0140-6736(05)78746-8.PubMed

175.

Arranz MJ, Munro J, Sham P, Kirov G, Murray RM, Collier DA, et al. Meta-analysis of studies on genetic variation in 5-HT2A receptors and clozapine response. Schizophr Res. 1998;32(2):93–9.PubMed

176.

Szekeres G, Keri S, Juhasz A, Rimanoczy A, Szendi I, Czimmer C, et al. Role of dopamine D3 receptor (DRD3) and dopamine transporter (DAT) polymorphism in cognitive dysfunctions and therapeutic response to atypical antipsychotics in patients with schizophrenia. Am J Med Genet B Neuropsychiatr Genet Off Publ Int Soc Psychiatr Genet. 2004;124B(1):1–5. doi:10.1002/ajmg.b.20045.

177.

Brandl EJ, Tiwari AK, Zhou X, Deluce J, Kennedy JL, Muller DJ, et al. Influence of CYP2D6 and CYP2C19 gene variants on antidepressant response in obsessive-compulsive disorder. Pharmacogenomics J. 2013. doi:10.1038/tpj.2013.12.PubMed

178.

Muller DJ, Brandl EJ, Hwang R, Tiwari AK, Sturgess JE, Zai CC, et al. The AmpliChip(R) CYP450 test and response to treatment in schizophrenia and obsessive compulsive disorder: a pilot study and focus on cases with abnormal CYP2D6 drug metabolism. Genet Test Mol Biomark. 2012;16(8):897–903. doi:10.1089/gtmb.2011.0327.

179.

Lynch T, Price A. The effect of cytochrome P450 metabolism on drug response, interactions, and adverse effects. Am Fam Physician. 2007;76(3):391–6.PubMed

180.

Dorado P, Penas-Lledo EM, Llerena A. CYP2D6 polymorphism: implications for antipsychotic drug response, schizophrenia and personality traits. Pharmacogenomics. 2007;8(11):1597–608. doi:10.2217/14622416.8.11.1597.PubMed

Title: Second Generation Antipsychotic-Induced Obsessive-Compulsive Symptoms in Schizophrenia: A Review of the Experimental Literature
Authors: Trehani M. Fonseka
Margaret A. Richter
Daniel J. Müller
Publication date: 01-11-2014
Publisher: Springer US
Published in: Current Psychiatry Reports / Issue 11/2014
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI: https://doi.org/10.1007/s11920-014-0510-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Second Generation Antipsychotic-Induced Obsessive-Compulsive Symptoms in Schizophrenia: A Review of the Experimental Literature

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 11/2014

Biomarkers in the Diagnosis of ADHD – Promising Directions

New Developments in the Genetics of Bipolar Disorder

Psychosis and Seizure Disorder: Challenges in Diagnosis and Treatment

The Role of Cortisol in First Episode of Psychosis: A Systematic Review

Genetics of Opiate Addiction

Use of EEG to Diagnose ADHD