Letter to the Editor: Aggravation Of Schizophrenia by Clomipramine in a Patient With Comorbid Obsessive-compulsive Disorder

Dear Editor, Different reports suggest that more than 20% of patients with schizophrenia may have significant obsessive-compulsive symptoms.¹ The combination of an antiobsessional agent (SSRIs or clomipramine) and an antipsychotic has been recommended as an appropriate and rather safe treatment in schizophrenia with comorbid obsessive-compulsive disorder (OCD).² However, the data from small studies or case reports suggest that combinations of an antipsychotic and antiobsessional agent might be associated with an increased risk of an acute psychotic decompensation.³ ⁴ Unfortunately, there are no larger studies that might tell us more about the incidence or timeframe of psychotic decompensations in these patients.