Do antiserotonergic antipsychotics induce OCD more frequently than first-generation antipsychotics in the long-term treatment of schizophrenia?

Objective: Antipsychotics with antiserotonergic receptor profile are suspected to induce obsessive compulsive symptoms in schizophrenic patients. We investigated the incidence of OCD in long-term treated schizophrenic patients who were either on classical antipsychotics or on second generation antipsychotics like clozapine, olanzapine or risperidone. Method: 50 schizophrenic patients with average duration of illness of 24 years and without OCD-symptoms at the beginning of disease were investigated in a cross-sectional study. They were classified into group 1 when exclusively on classical antipsychotics and into group 2 when receiving either clozapine, olanzapine or risperidone or a combination of those. symptoms of schizophrenia and of potential OCD were evaluated by PANSS and Y-BOCS and related to the present and life-time dose of antipsychotics. Results: Group 1 comprised 17 patients, group 2 33 patients. 9 patients developed OCD-symptoms, 7 of the 9 full OCD. Only 2 OCD-patients were in group 1, the others received mainly clozapine or a combination. Conclusion: Antipsychotics with antiserotonergic receptor profile, particularly clozapine, may in fact induce OCD in long-term treated schizophrenia.