Aripiprazole augmentation in treatment-refractory obsessive–compulsive disorder

Abstract

Obsessive–compulsive disorder (OCD) responds preferentially to cognitive behavioural therapy (CBT) and to pharmacological treatment such as antidepressant drugs like serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants with a predominantly serotonergic mechanism (Math and Janardhan Reddy 2007). Approximately half of OCD patients treated with an adequate trial of SSRIs fail to fully respond and continue to exhibit significant symptoms (Bloch et al 2006). Aripiprazole is a quinolinone derivative with a high affinity for dopamine D2 and D3 receptors as well as serotonin 5HT1A, 5-HT2A and 5-HT2B receptors. Aripiprazole is an atypical antipsychotic medication that works via partial dopaminergic, 5-HT1A, 5-HT2A and 5-HT2B receptor agonist activity (Rugino and Janvier 2005). We report a case of an OCD patient in whom a treatment regimen with escitalopram was successfully augmented with aripiprazole.