Agarwal Manya, Mehta Shivangi, Sidana Ajeet, Bhattacharya Sushmita, Das Subhash
Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India.
Department of Psychiatry, NEIGRIHMS, Shillong, Meghalaya, India.
Indian J Psychiatry. 2025 Jul;67(7):666-674. doi: 10.4103/indianjpsychiatry_757_24. Epub 2025 Jul 15.
Schizophrenia can coexist with obsessive-compulsive symptoms (OCSs). This study aimed to assess the efficacy of adding Fluoxetine-gold standard for the treatment of obsessive-compulsive disorder to the treatment regimen of patients with schizophrenia and OCS.
Patients diagnosed with schizophrenia (according to ICD-11) and OCS (assessed via the Y-BOCS Checklist) were randomized to either the Add-on Fluoxetine (received Fluoxetine in addition to their ongoing antipsychotic treatment) or the Antipsychotic only (continued with standard therapy) using a computer-generated random number table and assessed using PANSS, CGI-global impression, and SOFAS. Baseline assessments were conducted to evaluate sociodemographic and clinical factors and the severity of OCS. Both groups were monitored over 8 weeks for changes in psychotic and obsessive-compulsive symptoms.
Seventy patients of schizophrenia with OCS were recruited, 35 in each group. Both groups demonstrated significant improvement over 8 weeks in psychotic and obsessive-compulsive symptoms. The Add-on Fluoxetine exhibited earlier and more pronounced symptom improvements. A significant difference was found in the YBOCS compulsion score, with a median score of 8 (7-10) in the Add-on Fluoxetine and 11 (9.5-12) in the Antipsychotic only ( value of 0.003). Add-on Fluoxetine had a lower median score on CGI global improvement, 3 (3-3), and CGI efficacy index, 10 (10-10), than the Antipsychotic only, 4 (3-4) and 14 (10-14), respectively ( value < 0.001). Fluoxetine was well tolerated, with minimal reported side effects.
The findings suggest that adjunctive Fluoxetine treatment led to early resolution of psychopathology and improved overall outcomes in schizophrenia with co-occurring OCS.
精神分裂症可与强迫症状（OCS）共存。本研究旨在评估在精神分裂症合并OCS患者的治疗方案中添加治疗强迫症的金标准药物氟西汀的疗效。
根据国际疾病分类第11版（ICD-11）诊断为精神分裂症且通过耶鲁布朗强迫症量表（Y-BOCS）评估为OCS的患者，使用计算机生成的随机数字表随机分为加用氟西汀组（在持续抗精神病治疗基础上加用氟西汀）或仅用抗精神病药物组（继续标准治疗），并使用阳性和阴性症状量表（PANSS）、临床总体印象量表（CGI-global impression）和功能大体评定量表（SOFAS）进行评估。进行基线评估以评价社会人口学和临床因素以及OCS的严重程度。两组均在8周内监测精神病性症状和强迫症状的变化。
招募了70例精神分裂症合并OCS的患者，每组35例。两组在8周内精神病性症状和强迫症状均有显著改善。加用氟西汀组症状改善更早且更明显。YBOCS强迫症状评分存在显著差异，加用氟西汀组中位数为8（7-10），仅用抗精神病药物组为11（9.5-12）（P值为0.003）。加用氟西汀组在CGI总体改善评分上的中位数低于仅用抗精神病药物组，分别为3（3-3）和4（3-4），在CGI疗效指数上的中位数也低于仅用抗精神病药物组，分别为10（10-10）和14（（10-14）（P值<0.001）。氟西汀耐受性良好，报告的副作用极少。
研究结果表明，辅助使用氟西汀治疗可使合并OCS的精神分裂症患者的精神病理学症状早期缓解并改善总体结局。
