Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
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Treatment of Clozapine-induced Obsessive-compulsive Symptoms in Schizophrenia

정신분열병 환자에서 Clozapine치료로 유발된 강박증의 치료

  • Kim, Yun-Jung (Department of Psychiatry, College of Medicine, Soonchunhyang University, Cheonan Hospital) ;
  • Kwon, Young-Joon (Department of Psychiatry, College of Medicine, Soonchunhyang University, Cheonan Hospital) ;
  • Jung, Hee-Yeun (Department of Psychiatry, College of Medicine, Soonchunhyang University, Cheonan Hospital) ;
  • Shim, Sae-Hoon (Department of Psychiatry, College of Medicine, Soonchunhyang University, Cheonan Hospital) ;
  • Jung, Han-Yong (Department of Psychiatry, College of Medicine, Soonchunhyang University, Bucheon Hospital) ;
  • Han, Sang-Woo (Department of Psychiatry, College of Medicine, Soonchunhyang University, Seoul Hospital)
  • 김윤정 (순천향대학교 의과대학 천안병원 신경정신과학교실) ;
  • 권영준 (순천향대학교 의과대학 천안병원 신경정신과학교실) ;
  • 정희연 (순천향대학교 의과대학 천안병원 신경정신과학교실) ;
  • 심세훈 (순천향대학교 의과대학 천안병원 신경정신과학교실) ;
  • 정한용 (순천향대학교 의과대학 부천병원 신경정신과학교실) ;
  • 한상우 (순천향대학교 의과대학 서울병원 신경정신과학교실)
  • Published : 2005.11.30
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Abstract

Background:Clozapine is a unique atypical antipsychotic medication. It is considered to be superior, even amongst the newer agents, in treatment-resistant schizophrenia. However, de novo emergence or exacerbation of obsessive-compulsive(OC) symptoms during treatment with clozapine has been reported. We prospectively evaluated 19 cases which newly developed OC symptoms during clozapine treatment and discussed the treatment of OC symptoms induced by it. Methods:We recruited 19 patients(8 males, 11 females) with a DSM-IV diagnosis of schizophrenia and schizoaffective disorder who had developed OC symptoms during clozapine treatment. OC symptoms were assessed using the Padua-ICMA and YBOCS on a monthly basis over three months. Results:Eleven female and eight male patients were enrolled and the average age of patients was 32.8 years. At baseline, no patients showed OC symptoms. Moderate to severe OC symptoms appeared with mean daily dose of 298.68 mg of clozapine. There were no significant differences in improving OC symptoms between the clozapine dose reduction group and the OC treatment group. Conclusion:We noticed the possibility that the appearance of OC symptoms is connected with the effect of clozapine. The clozapine-induced OC symptoms were improved both by reducing clozapine daily doses, and by adding OC treatment drugs. With other atypical antipsychotics now available, to know and treat the side effects of clozapine would be of considerable value, offering clinical guidance in making a decision on treatment-resistant schizophrenia.

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