Treatment of Obsessive Symptoms in Schizophrenic Patient with a Risperidone-Fluoxetine Combination

Choi, Myong Su; Chung, Sang Keun; Hwang, Ik Keun

Abstract

Recent studies have reported that obsessive-compulsive (OC) symptoms are highly prevalent in schizophrenia, and schizophrenic patients with OC symptoms have a poorer clinical course compared to those without OC symptoms. In spite of many previous case reports, treatment of OC symptoms in schizophrenia has not been systematically studied. We report a patient with chronic schizophrenia who had obsessive symptoms such as bizarre, stereotyped behaviors. Treatment with olanzapine and risperidone, resulted in partial response for his psychotic symptoms, respectively. The obsessive symptoms, however, persisted and fluoxetine was added to the risperidone regimen. After 4 weeks of combination treatment, fluoxetine was titrated up to 80 mg/day and his obsessive symptoms became less in frequency and intensity. After 7 weeks on combination treatment of risperidone and fluoxetine, obsessive symptoms resulted in a significant reduction. On the 20 months of following, he remained in a recovered state and had been treated with risperidone 4 mg/day, and fluoxetine 20 mg/day.