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AUDIO: Despite low efficacy in OCD, adjunct antipsychotics still prescribed


 

EXPERT ANALYSIS FROM THE AADA ANNUAL CONFERENCE

CHICAGO – At best, only a third of adults treated with selective serotonin reuptake inhibitors for obsessive-compulsive disorder respond to adjunctive therapy with the second-generation antipsychotic risperidone.

That’s according to Dr. H. Blair Simpson, professor of psychiatry at Columbia University and the director of the Center for Obsessive-Compulsive and Related Disorders and the Anxiety and Related Disorders Clinic at the New York State Psychiatric Institute/Columbia University.

"And if they do, typically you will know within about 4 weeks," said Dr. Simpson at the annual conference of the Anxiety and Depression Association of America.

So, why do so many patients with OCD – even pediatric ones for whom there are even fewer efficacy data – receive the second-generation antipsychotic (SGA) instead of cognitive-behavioral therapy, which does have more efficacy data? And for patients who do respond, what is the best way to titrate them off the SGA?

In an interview, Dr. Simpson and her colleague Dr. Moira Rynn, director of the Child and Adolescent Psychiatric Evaluation Service at the New York State Psychiatric Institute/Columbia University, explore the answers to these questions, as well as discuss whether two standards of mental health care are developing by default – and if so, why, as academic centers offer a wider range of treatments for refractory cases of OCD than do community-based clinicians.

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