A double-blind, placebo-controlled trial of olanzapine addition in fluoxetine-refractory obsessive-compulsive disorder

• Published in: Biological psychiatry (1969) 2004-03, Vol.55 (5), p.553-555
• Main Authors: Shapira, Nathan A, Ward, Herbert E, Mandoki, Miguel, Murphy, Tanya K, Yang, Mark C.K, Blier, Pierre, Goodman, Wayne K
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Analysis of Variance; Antipsychotic; Antipsychotic Agents - administration & dosage; Anxiety disorders. Neuroses; Benzodiazepines - administration & dosage; Biological and medical sciences; Double-Blind Method; Drug Resistance; Drug Therapy, Combination; Female; Fluoxetine - administration & dosage; Humans; Male; Medical sciences; Middle Aged; nonresponders; obsessive-compulsive disorder; Obsessive-Compulsive Disorder - drug therapy; Obsessive-compulsive disorders; olanzapine; partial responders; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; serotonin reuptake inhibitor; Serotonin Uptake Inhibitors - administration & dosage; Treatment Outcome
• ISSN: 0006-3223; 1873-2402
• DOI: 10.1016/j.biopsych.2003.11.010

One of the few combination approaches to the treatment of obsessive-compulsive disorder (OCD) with encouraging support is the addition of an antipsychotic to a serotonin reuptake inhibitor. The study consisted of a 6-week, placebo-controlled addition of olanzapine 5–10 mg (6.1 ± 2.1 mg, mean ± SD) to fluoxetine in OCD subjects who were partial or nonresponders to an 8-week, open-label fluoxetine trial (40 mg in 43 subjects, 20 mg in 1 subject). Both the fluoxetine-plus-olanzapine (n = 22) and fluoxetine-plus-placebo (n = 22) groups improved significantly over 6 weeks [F(3,113) = 11.64, p < .0001] according to Yale-Brown Obsessive Compulsive Scale scores with repeated-measures analysis of variance; however, the treatment × time interaction was not significant for olanzapine versus placebo addition to fluoxetine. These findings indicate no additional advantage of adding olanzapine for 6 weeks in OCD patients who have not had a satisfactory response to fluoxetine for 8 weeks, compared with extending the monotherapy trial.