Iranian Red Crescent Medical Journal

Published by: Kowsar

The Efficacy of Aripiprazole versus Risperidone as Augmentation Therapy in the Treatment of the Resistant Obsessive-Compulsive Disorder: A Double-Blind, Randomized Clinical Trial

Fatemeh Assarian 1 , Fatemeh Sadat Ghoreishi 1 , * , Mahbubeh Borna 2 and Mohammadreza Razzaghof 3
Authors Information
1 Assistant Professor, Department of Psychiatry, Kashan University of Medical Sciences, Kashan, IR Iran
2 Department of Psychiatry, Kashan University of Medical Sciences, Kashan, IR Iran
3 School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran; []
Article information
  • Iranian Red Crescent Medical Journal: July 2018, 20 (7); e41418
  • Published Online: October 10, 2016
  • Article Type: Research Article
  • Received: August 11, 2016
  • Revised: September 10, 2016
  • Accepted: September 25, 2016
  • DOI: 10.5812/ircmj.41418

To Cite: Assarian F, Ghoreishi F S, Borna M, Razzaghof M. The Efficacy of Aripiprazole versus Risperidone as Augmentation Therapy in the Treatment of the Resistant Obsessive-Compulsive Disorder: A Double-Blind, Randomized Clinical Trial, Iran Red Crescent Med J. 2018 ; 20(7):e41418. doi: 10.5812/ircmj.41418.

Copyright © 2016, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Sadock BJ. Sadock, and P. Ruiz, Kaplan and Sadock's Synopsis of Psychiatry. Wolters Kluwer Health; 2014.
  • 2. Sadock BJ. Kaplan & Sadock's comprehensive textbook of psychiatry. 2. Philadelphia: Williams & wilkinslippincott; 2009.
  • 3. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349(9063):1436-42. doi: 10.1016/S0140-6736(96)07495-8. [PubMed: 9164317].
  • 4. Koran LM. Quality of life in obsessive-compulsive disorder. Psychiatr Clin North Am. 2000;23(3):509-17. [PubMed: 10986724].
  • 5. Ahmadvand A. Prevalence of mental disorders in general population of Kashan City. Iranian J Epidemiol. 2010;6(2):16-24.
  • 6. Mohammadi MR, Ghanizadeh A, Rahgozar M, Noorbala AA, Davidian H, Afzali HM, et al. Prevalence of obsessive-compulsive disorder in Iran. BMC Psychiatry. 2004;4:2. doi: 10.1186/1471-244X-4-2. [PubMed: 15018627].
  • 7. Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry. 2006;11(7):622-32. doi: 10.1038/ [PubMed: 16585942].
  • 8. Pallanti S, Quercioli L. Treatment-refractory obsessive-compulsive disorder: methodological issues, operational definitions and therapeutic lines. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30(3):400-12. doi: 10.1016/j.pnpbp.2005.11.028. [PubMed: 16503369].
  • 9. Dold M, Aigner M, Lanzenberger R, Kasper S. [Efficacy of antipsychotic augmentation therapy in treatment-resistant obsessive-compulsive disorder: a meta-analysis of double-blind, randomised, placebo-controlled trials]. Fortschr Neurol Psychiatr. 2011;79(8):453-66. doi: 10.1055/s-0031-1273397. [PubMed: 21809258].
  • 10. Hollander E. Obsessive-compulsive and spectrum disorders: Overview and quality of life issues. J clin psychiatr. 1996.
  • 11. Decloedt EH, Stein DJ. Current trends in drug treatment of obsessive-compulsive disorder. Neuropsychiatr Dis Treat. 2010;6:233-42. [PubMed: 20520787].
  • 12. Afshar H, Roohafza H, Mohammad-Beigi H, Haghighi M, Jahangard L, Shokouh P, et al. N-acetylcysteine add-on treatment in refractory obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled trial. J Clin Psychopharmacol. 2012;32(6):797-803. doi: 10.1097/JCP.0b013e318272677d. [PubMed: 23131885].
  • 13. Carey PD. Quetiapine augmentation of serotonin reuptake inhibitors in treatment-refractory obsessive-compulsive disorder: is response to treatment predictable? Int Clini Psychopharmacol. 2012;27(6):321-5. doi: 10.1097/yic.0b013e3283576881.
  • 14. Dhansay Y, Ipser J, Stein DJ. Pharmacotherapy augmentation strategies in treatment‐resistant anxiety disorders. The Cochrane Library; 2005.
  • 15. Skapinakis P, Papatheodorou T, Mavreas V. Antipsychotic augmentation of serotonergic antidepressants in treatment-resistant obsessive-compulsive disorder: a meta-analysis of the randomized controlled trials. Eur Neuropsychopharmacol. 2007;17(2):79-93. doi: 10.1016/j.euroneuro.2006.07.002. [PubMed: 16904298].
  • 16. Vulink NC, Figee M, Denys D. Review of atypical antipsychotics in anxiety. Eur Neuropsychopharmacol. 2011;21(6):429-49. doi: 10.1016/j.euroneuro.2010.12.007. [PubMed: 21345655].
  • 17. Sayyah M, Sayyah M, Boostani H, Ghaffari SM, Hoseini A. Effects of aripiprazole augmentation in treatment-resistant obsessive-compulsive disorder (a double blind clinical trial). Depress Anxiety. 2012;29(10):850-4. doi: 10.1002/da.21996. [PubMed: 22933237].
  • 18. Maina G, Pessina E, Albert U, Bogetto F. 8-week, single-blind, randomized trial comparing risperidone versus olanzapine augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder. Eur Neuropsychopharmacol. 2008;18(5):364-72. doi: 10.1016/j.euroneuro.2008.01.001. [PubMed: 18280710].
  • 19. Selvi Y, Atli A, Aydin A, Besiroglu L, Ozdemir P, Ozdemir O. The comparison of aripiprazole and risperidone augmentation in selective serotonin reuptake inhibitor-refractory obsessive-compulsive disorder: a single-blind, randomised study. Hum Psychopharmacol. 2011;26(1):51-7. doi: 10.1002/hup.1169. [PubMed: 21308781].
  • 20. Pessina E, Albert U, Bogetto F, Maina G. Aripiprazole augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder: a 12-week open-label preliminary study. Int Clin Psychopharmacol. 2009;24(5):265-9. doi: 10.1097/YIC.0b013e32832e9b91. [PubMed: 19629012].
  • 21. Kim SW, Dysken MW, Katz R. Rating scales for obsessive compulsive disorder. Psychiatr Ann. 1989;19(2):74-9. doi: 10.3928/0048-5713-19890201-07.
  • 22. Rajezi Esfahani S. Reliability and Validity of the Persian version of the Yale-Brown Obsessive-Compulsive scale (Y-BOCS). Iran J Psychiatr Clin Psychol. 2012;17(4):297-303.
  • 23. Shabani M, Ghoreishi S. Olanzapine Augmentation Therapy in Patients with the Obsessive-Compulsive Disorder Resistant to Treatment. Zanjan Uni Med ASci J. 2009;17(66):21-8.
  • 24. First MB. User's guide for the Structured clinical interview for DSM-IV axis I disorders SCID-I: clinician version. USA: American Psychiatric Pub; 1997.
  • 25. First MB. User's guide for the structured clinical interview for DSM-IV axis II personality disorders: SCID-II. USA: American Psychiatric Pub; 1997.
  • 26. Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, et al. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006-11. [PubMed: 2684084].
  • 27. Delle Chiaie R, Scarciglia P, Pasquini M, Caredda M, Biondi M. Aripiprazole augmentation in patients with resistant obsessive compulsive disorder: a pilot study. Clin Pract Epidemiol Ment Health. 2011;7:107-11. doi: 10.2174/1745017901107010107. [PubMed: 21686322].
  • 28. Higuma H, Kanehisa M, Maruyama Y, Ishitobi Y, Tanaka Y, Tsuru J, et al. Aripiprazole augmentation in 13 patients with refractory obsessive-compulsive disorder: a case series. World J Biol Psychiatry. 2012;13(1):14-21. doi: 10.3109/15622975.2010.551667. [PubMed: 22256827].
  • 29. Connor KM, Payne VM, Gadde KM, Zhang W, Davidson JR. The use of aripiprazole in obsessive-compulsive disorder: preliminary observations in 8 patients. J Clin Psychiatry. 2005;66(1):49-51. [PubMed: 15669888].
  • 30. Ashton AK. Aripiprazole augmentation of combination escitalopram and sertraline in the treatment of refractory obsessive-compulsive disorder. Psychiatr (Edgmont). 2005;2(1):18.
  • 31. da Rocha FF, Correa H. Successful augmentation with aripiprazole in clomipramine-refractory obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2007;31(7):1550-1. doi: 10.1016/j.pnpbp.2007.07.008. [PubMed: 17692447].
  • 32. Friedman S, Abdallah TA, Oumaya M, Rouillon F, Guelfi JD. Aripiprazole augmentation of clomipramine-refractory obsessive-compulsive disorder. J Clin Psychiatry. 2007;68(6):972-3. [PubMed: 17592930].
  • 33. Masi G, Pfanner C, Millepiedi S, Berloffa S. Aripiprazole augmentation in 39 adolescents with medication-resistant obsessive-compulsive disorder. J Clin Psychopharmacol. 2010;30(6):688-93. [PubMed: 21105283].
  • 34. Matsunaga H, Hayashida K, Maebayashi K, Mito H, Kiriike N. A case series of aripiprazole augmentation of selective serotonin reuptake inhibitors in treatment-refractory obsessive compulsive disorder. Int J Psychiatry Clin Pract. 2011;15(4):263-9. doi: 10.3109/13651501.2011.605958. [PubMed: 22121999].
  • 35. Muscatello MR, Bruno A, Pandolfo G, Mico U, Scimeca G, Romeo VM, et al. Effect of aripiprazole augmentation of serotonin reuptake inhibitors or clomipramine in treatment-resistant obsessive-compulsive disorder: a double-blind, placebo-controlled study. J Clin Psychopharmacol. 2011;31(2):174-9. doi: 10.1097/JCP.0b013e31820e3db6. [PubMed: 21346614].
  • 36. Ozturk M, Coskun M. Successful aripiprazole augmentation in a child with drug-resistant obsessive-compulsive disorder. J Clin Psychopharmacol. 2009;29(6):607-9. doi: 10.1097/JCP.0b013e3181bfe068. [PubMed: 19910732].
  • 37. Sarkar R, Klein J, Kruger S. Aripiprazole augmentation in treatment-refractory obsessive-compulsive disorder. Psychopharmacology (Berl). 2008;197(4):687-8. doi: 10.1007/s00213-008-1091-1. [PubMed: 18264798].
  • 38. Storch EA, Lehmkuhl H, Geffken GR, Touchton A, Murphy TK. Aripiprazole augmentation of incomplete treatment response in an adolescent male with obsessive-compulsive disorder. Depress Anxiety. 2008;25(2):172-4. doi: 10.1002/da.20303. [PubMed: 17340610].
  • 39. Erzegovesi S, Guglielmo E, Siliprandi F, Bellodi L. Low-dose risperidone augmentation of fluvoxamine treatment in obsessive-compulsive disorder: a double-blind, placebo-controlled study. Eur Neuropsychopharmacol. 2005;15(1):69-74. doi: 10.1016/j.euroneuro.2004.04.004. [PubMed: 15572275].
  • 40. Li X, May RS, Tolbert LC, Jackson WT, Flournoy JM, Baxter LR. Risperidone and haloperidol augmentation of serotonin reuptake inhibitors in refractory obsessive-compulsive disorder: a crossover study. J Clin Psychiatry. 2005;66(6):736-43. [PubMed: 15960567].
  • 41. Arias HF. Effectiveness and tolerability of addition of risperidone in obsessive-compulsive disorder with poor response to serotonin reuptake inhibitors. Actas Espa-Olas De Psiquiatría. 2005;34(3):147-52.
  • 42. Sun TF, Lin PY, Wu CK. Risperidone augmentation of specific serotonin reuptake inhibitors in the treatment of refractory obsessive-compulsive disorder: report of two cases. Chang Gung Med J. 2001;24(9):587-92. [PubMed: 11725630].
  • 43. Yoshimura R, Kaneko S, Shinkai K, Nakamura J. Successful treatment for obsessive-compulsive disorder with addition of low-dose risperidone to fluvoxamine: implications for plasma levels of catecholamine metabolites and serum brain-derived neurotrophic factor levels. Psychiatry Clin Neurosci. 2006;60(3):389-93. doi: 10.1111/j.1440-1819.2006.01519.x. [PubMed: 16732759].
  • 44. McDougle CJALHP. Antiobsessional effect of risperidone add-on treatment in serotonin reuptake inhibitor-refractory obsessive-compulsive disorder may be dose-dependent. Arch General Psychiatr. 2002;59(5):472-3. doi: 10.1001/archpsyc.59.5.472.
  • 45. Boricevic Marsanic, V . Misdiagnosis and exacerbation of unusual obsessive-compulsive disorder presentation with Risperidone and Clozapine in an adolescent girl-a case report. Collegium Antropologicum. 2011;35(1):293-6.
  • 46. Stein DJ. Obsessive-compulsive disorder. Lancet. 2002;360(9330):397-405. doi: 10.1016/S0140-6736(02)09620-4. [PubMed: 12241794].
  • 47. Kapur S, Zipursky RB, Remington G, Jones C, DaSilva J, Wilson AA, et al. 5-HT2 and D2 receptor occupancy of olanzapine in schizophrenia: a PET investigation. Am J Psychiatry. 1998;155(7):921-8. doi: 10.1176/ajp.155.7.921. [PubMed: 9659858].

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