{"title":"Efficacy of pharmacological treatment in OCD comorbid with tic disorder: Systematic review and meta-analysis","authors":"","doi":"10.1016/j.jpsychires.2024.09.048","DOIUrl":null,"url":null,"abstract":"<div><div>Up to 30% of subjects with obsessive compulsive disorder (OCD) also have a lifetime tic disorder. Several meta-analyses of pharmaceutical or psychotherapeutic interventions for the management of OCD have been published, but none specifically on patients with OCD comorbid with tics. The literature regarding pharmacological treatments of patients with this condition is mainly focused on studies of OCD. After a search of the Cochrane, EMBASE, PubMed, PsychINFO and Science Direct databases, we performed a proportion meta-analysis of the percentage of patients whose condition improved and a paired meta-analysis of the change in the OCD score (Y-BOCS). Twelve case reports were retained for qualitative analysis and 14 articles for meta-analysis. Case reports showed better efficacy of combined antidepressant-antipsychotic treatment for OCD comorbid with tic disorder. The meta-analysis showed an improvement in 29% [18–42] of patients with antidepressants. Although there was no significant difference with placebo add-on, in antidepressant-resistant OCD patients, adding an antipsychotic to the antidepressant regimen led to an increase in the number of patients who improved (67% [45–86] vs 7% [0–35]) and seemed to show a decrease in the Y-BOCS score (−10.06 [-20.38; 0.26] vs (−3.61 [-9.08; 13.85]). Our study provides new evidence on the pharmacological treatment of OCD comorbid with tics. In some patients, the condition is improved by a first-line antidepressant. In case of non-response or insufficient efficacy of antidepressants, add-on treatment with certain antipsychotics can be implemented.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of psychiatric research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022395624005703","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Up to 30% of subjects with obsessive compulsive disorder (OCD) also have a lifetime tic disorder. Several meta-analyses of pharmaceutical or psychotherapeutic interventions for the management of OCD have been published, but none specifically on patients with OCD comorbid with tics. The literature regarding pharmacological treatments of patients with this condition is mainly focused on studies of OCD. After a search of the Cochrane, EMBASE, PubMed, PsychINFO and Science Direct databases, we performed a proportion meta-analysis of the percentage of patients whose condition improved and a paired meta-analysis of the change in the OCD score (Y-BOCS). Twelve case reports were retained for qualitative analysis and 14 articles for meta-analysis. Case reports showed better efficacy of combined antidepressant-antipsychotic treatment for OCD comorbid with tic disorder. The meta-analysis showed an improvement in 29% [18–42] of patients with antidepressants. Although there was no significant difference with placebo add-on, in antidepressant-resistant OCD patients, adding an antipsychotic to the antidepressant regimen led to an increase in the number of patients who improved (67% [45–86] vs 7% [0–35]) and seemed to show a decrease in the Y-BOCS score (−10.06 [-20.38; 0.26] vs (−3.61 [-9.08; 13.85]). Our study provides new evidence on the pharmacological treatment of OCD comorbid with tics. In some patients, the condition is improved by a first-line antidepressant. In case of non-response or insufficient efficacy of antidepressants, add-on treatment with certain antipsychotics can be implemented.
期刊介绍:
Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research:
(1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors;
(2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology;
(3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;