Aripiprazole augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder: a 10-week open-label study

Abstract

Studies investigating the aripiprazole augmentation treatment of serotonin reuptake inhibitor (SRI)-resistant obsessive-compulsive disorder (OCD) are insufficient. The aim of the present pilot study was to investigate the efficacy and tolerability of flexible doses of aripiprazole as an augmenting agent in SRI-resistant OCD patients. OCD patients who met the criteria of this study were followed up with flexible doses of aripiprazole augmentation over a 10-week period. Effectiveness of treatment was evaluated via the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Clinical Global Impressions-Severity of Illness (CGI-S) and -Improvement (CGI-I) scales. At the end of the 10-week follow-up period, patients who showed an improvement of ≥30% for the Y-BOCS total score from baseline were considered responders. Thirty patients met the study inclusion criteria; three patients did not agree to participate, and four patients dropped out of the study. The differences between baseline and scores at 10 weeks for the parameters studied were as follows: Y-BOCS scores: 32.0±6.3-24.0±8.1 (Z=4.2, P<0.05); Y-BOCS compulsion subscore: 15.0±4.2-11.5±4.3 (Z=4.01, P<0.05); Y-BOCS obsession subscore: 17.0±2.6-12.4±4.0 (Z=4.1, P<0.05); and CGI-S scores: 4.8±0.8-3.1±1.2 (Z=3.9, P<0.05). Patients showed a significant improvement over the 10-week study period; however, only seven of 23 patients (30.4%) who completed the study met the criteria determined for treatment response. Despite the limited number of cases and open-label design of this study, results support the notion that adding aripiprazole to SRIs could be a valid strategy for treatment-resistant OCD patients.