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Augmentation strategy fluoxetine and lurasidone in the treatment of OCD with comorbid Restrictive Anorexia: a case report

Published online by Cambridge University Press:  01 September 2022

L. Orsolini ,
S. Bellagamba ,
S. Tempia Valenta ,
V. Salvi  and
U. Volpe
L. Orsolini
Affiliation:
Unit of Clinical Psychiatry, Polytechnic University of Marche, Ancona, Italy, Department Of Neurosciences/dimsc, Ancona, Italy
S. Bellagamba*
Affiliation:
Polytechnic University of Marche, Department Of Clinical Neurosciences/dimsc, School Of Medicine, Unit Of Psychiatry, Ancona, Italy
S. Tempia Valenta
Affiliation:
Unit of Clinical Psychiatry, Polytechnic University of Marche, Ancona, Italy, Department Of Neurosciences/dimsc, Ancona, Italy
V. Salvi
Affiliation:
Unit of Clinical Psychiatric, Polytechnic University of Marche, Ancona, Italy, Department Of Neurosciences/dimsc, Ancona, Italy
U. Volpe
Affiliation:
Unit of Clinical Psychiatry, Polytechnic University of Marche, Ancona, Italy, Department Of Neurosciences/dimsc, Ancona, Italy
*
*Corresponding author.

Abstract

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Introduction

Obsessive-Compulsive Disorder (OCD) is characterized by the presence of intrusive thought (obsessions) and ritualistic behaviour (compulsions). First-choice psychopharmacological treatment is based on serotonin reuptake inhibitors (SRIs). However, about half of OCD do not or partially respond to SRIs (TR-OCD) and need an augmentation strategy with second-generation antipsychotics (SGAs).

Objectives

We report a case of severe OCD with comorbid anorexia nervosa, restrictive type (AN-r) treated with fluoxetine (up to 40 mg daily) and lurasidone (37 mg daily bedtime) augmentation.

Methods

At baseline and monthly 4-months-follow-up were administered Y-BOCS-II (Yale-Brown Obsessive Compulsive Scale), CGI-S (Clinical Global Impression-Severity), SCL-90 (Symptom Checklist-90 items) and EDI-3 (Eating Disorder Inventory-3).

Results

Compared to the baseline, a clinically significant clinical response was observed on OC at Y-BOCS-II (≥35% Y-BOCS reduction) and eating symptomatology at EDI-3 after 1 month of augmentation treatment, while a full remission after 3 months (Y-BOCS scoring ≤ 14)(p<0.01). We also noticed, throughout clinical follow up interviews, improvement in patient’s social skills and life satisfaction.

Conclusions

Further longitudinal and real-world effectiveness studies are needed to confirm these preliminary findings and investigate the potential of lurasidone augmentation strategy in attenuating OC symptomatology in TR-OCD and whereas a comorbid AN-r is present.

Disclosure

No significant relationships.

Keywords

obsessive-compulsive disorderAnorexia nervosalurasidone
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S646
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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