The obsessive-compulsive disorder (OCD) frequently co-occurs with schizophrenia and causes significant impairment. Published data are scarce regarding treating such complicated patients. In schizophrenia with obsessive-compulsive disorder, experts suggest antipsychotics and antiobsessive agents as the best treatment. Yet no literature exists regarding the use of high doses (up to 40 mg/day) of Escitalopram. 

An open-label prospective study thus investigated the efficacy, short-term safety, and tolerability of Escitalopram (in doses up to 40 mg) in patients with schizophrenia and obsessive-compulsive disorder. 

Patients received increasing doses of Escitalopram for 13 weeks. 86.67% of the participants completed the study. Escitalopram administration significantly improved the total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores; Y-BOCS-Obsession and Y-BOCS-Compulsion subscales scores; the Positive and Negative Syndrome Scale scores and Clinical Global Impression-severity scale scores. 

Thus, Escitalopram, up to 40 mg/day, is well tolerated and may be beneficial in managing schizophrenia and obsessive-compulsive disorder patients. Further studies must confirm this finding and assess its long-term safety.

Source: International Clinical Psychopharmacology. July 2019; 34(4):179-183. doi: 10.1097/YIC.0000000000000266