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The effectiveness of high-dose escitalopram in the treatment of patients suffering from schizophrenia with comorbid obsessive-compulsive disorder

an open-label study

Rubin-Kahana, Dafna Saraa,,*,,†; Shelef, Assafb,,*; Weizman, Abrahamc,,†; Gothelf, Dorond,,e; Timinski, Igora,,†; Spivak, Barucha,,†; Stryjer, Rafaela,,†

International Clinical Psychopharmacology: July 2019 - Volume 34 - Issue 4 - p 179–183
doi: 10.1097/YIC.0000000000000266
Original Articles
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Obsessive-compulsive disorder frequently co-occur with schizophrenia causing a significant impairment. There is a paucity of published data on the treatment of such complicated patients. It has been suggested that the combination of antipsychotics and antiobsessive agents is the best treatment for schizophrenia with obsessive-compulsive disorder; however, there is no published data regarding the use of high dose (up to 40 mg/day) escitalopram. This open-label, prospective study was designed to investigate the efficacy, short-term safety and tolerability of escitalopram in doses up to 40 mg in patients with schizophrenia and obsessive-compulsive disorder. Patients were treated with increasing doses of escitalopram for 13 weeks. Thirteen patients (86.67%) completed the study. A significant improvement was observed in the total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores and in the scores of Y-BOCS-Obsession and Y-BOCS-Compulsion subscales. Furthermore, a significant improvement was observed in the total scores of the Positive and Negative Syndrome Scale and Clinical Global Impression-severity scale. Escitalopram, up to 40 mg/day was well tolerated and may be beneficial in the management of patients with schizophrenia and obsessive-compulsive disorder. Further studies are needed to confirm this finding and to assess long-term safety.

aBeer-Yaacov – Ness-Ziona Mental Health Center

bAbarbanel Mental Health Center, Bat-Yam

cFelsenstein Medical Research Center, Petah Tikva

dThe Child Psychiatry Division, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer

eSagol School of Neuroscience, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel

* Dr. Kahana and Dr. Shelef contributed equally to the writing of this article.

† All the authors are affiliated with Sackler Faculty of Medicine, Tel-Aviv, Israel.

Received 26 December 2018 Accepted 3 April 2019

Current address: Dr. Stryjer is affiliated with Abarbanel Mental Health Center, Bat-Yam, Israel, affiliated with Sackler Faculty of Medicine, Tel-Aviv, Israel

Correspondence to Dr. Rafael Stryjer, MD, Abarbanel Mental Health Center, 15 KKL Street, Bat-Yam, 59100, Israel Tel: +972 3 5552611; fax: 972 3-5552842; e-mail: stryjer@gmail.com

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