2014/11/29 by David Veale, Sarah Miles, Nicola Smallcombe +3 · 159 citations
Psychology · Medicine · #Obsessive-Compulsive Spectrum Disorders #Personality Disorders and Psychopathology #Gambling Behavior and Treatments #Risperidone #Aripiprazole #Olanzapine #Quetiapine #Psychiatry #Placebo #Atypical antipsychotic #Medicine #Cochrane Library #Randomized controlled trial #Meta-analysis #PsycINFO #Antipsychotic #Ziprasidone #Psychology #MEDLINE #Schizophrenia (object-oriented programming) #Internal medicine
paper · pdf · doi:10.1186/s12888-014-0317-5
published in BMC Psychiatry 14(1), 317 (BioMed Central)
openalex publication_date 2014/11/29 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
BACKGROUND: In 2006, the National Institute of Clinical and Health Excellence (NICE) guidelines for Obsessive Compulsive Disorder (OCD) recommended anti-psychotics as a class for SSRI treatment resistant OCD. The article aims to systematically review and conduct a meta-analysis on the clinical effectiveness of atypical anti-psychotics augmenting an SSRI. METHODS: Studies that were double-blind randomized controlled trials of an atypical antipsychotic against a placebo, for a minimum of 4 weeks, in adults with OCD, were included. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores were the primary outcome measure. Inclusion criteria included Y-BOCS score of 16 or more and at least one adequate trial of a SSRI or clomipramine for at least 8 weeks prior to randomization. Data sources included Medline, Embase, PsycINFO, Cochrane Database of Systematic Reviews (CDSR), trial registries and pharmaceutical databases and manufacturers up to September 2013. Forest-plots were drawn to display differences between drug and placebo on the Y-BOCS. RESULTS: Two studies found aripiprazole to be effective in the short-term. There was a small effect-size for risperidone or anti-psychotics in general in the short-term. We found no evidence for the effectiveness of quetiapine or olanzapine in comparison to placebo. CONCLUSIONS: Risperidone and aripiprazole can be used cautiously at a low dose as an augmentation agent in non-responders to SSRIs and CBT but should be monitored at 4 weeks to determine efficacy.