Emergence of obsessive compulsive symptoms during treatment with clozapine.

BACKGROUND

Clozapine differs from other currently available antipsychotics in its prominent serotonin blockade. We explore the relationship between clozapine and obsessive compulsive symptoms, which have been linked to deficient serotonin.

METHOD

We reviewed our experience in treating 49 chronic schizophrenic patients with clozapine.

RESULTS

Five patients were identified who experienced either de novo obsessive compulsive symptoms or exacerbation of preexistent symptoms. Clinical details are provided for each case.

CONCLUSION

Clozapine may produce or unmask obsessive compulsive symptoms. This may reflect a variation on the normal course of clinical improvement, or may more specifically result from clozapine's atypical pattern of CNS receptor antagonism. Further attention to this issue is warranted.