Risperidone May Worsen Fluoxetine-Treated OCD

Sir: Several recent studies have suggested that risperidone may usefully augment serotonin reuptake inhibitor (SRI) therapy in refractory obsessive-compulsive disorder (OCD). One study found that 14 of 16 refractory OCD patients experienced substantial improvement in obsessive-compulsive symptoms within 3 weeks of the initiation of an SRI-risperidone combination; indeed, certain patients improved dramatically within days. A second study reported that 7 of 14 OCD patients responded with the addition of risperidone after having failed to respond to SRI therapy alone. A retrospective chart review discovered that 8 patients with OCD who had failed an SRI trial responded within a month of supplementation with risperidone.