Is Aripiprazole (Abilify) effective for treating Obsessive-Compulsive Disorder (OCD)?

From the Guidelines

Abilify should not be used as a first-line treatment for obsessive-compulsive disorder (OCD), but rather as an augmentation strategy when first-line treatments, such as cognitive behavioral therapy (CBT) or selective serotonin reuptake inhibitors (SSRIs), have not provided adequate relief. The most recent and highest quality study 1 suggests that CBT, particularly exposure and response prevention (ERP), is the psychological treatment of choice for OCD, with larger effect sizes than pharmacological therapy. SSRIs are the first-line pharmacological treatment for OCD, with higher doses associated with greater treatment efficacy, but also higher rates of dropout due to adverse effects 1.

When considering augmentation strategies for treatment-resistant OCD, the evidence suggests that combining SSRIs with CBT or using antipsychotics, such as Abilify, may be effective 1. However, the use of Abilify should be carefully considered due to its potential side effects, including restlessness, weight gain, and metabolic changes. The recommended dose of Abilify for OCD is typically ranging from 2.5 to 15 mg daily, starting at a lower dose and gradually increasing as needed, and it should be used in conjunction with an SSRI rather than as a monotherapy. Regular monitoring for side effects is crucial, particularly for movement disorders, weight changes, and metabolic parameters.

Some key points to consider when using Abilify for OCD include:

• CBT, particularly ERP, is the preferred first-line treatment for OCD
• SSRIs are the first-line pharmacological treatment for OCD
• Abilify may be used as an augmentation strategy for treatment-resistant OCD
• Careful monitoring for side effects is necessary when using Abilify
• The use of Abilify should be individualized and based on the patient's specific needs and circumstances.

From the Research

Abilify (Aripiprazole) for OCD

• Abilify, also known as aripiprazole, is an atypical antipsychotic that has been studied as an augmentation treatment for obsessive-compulsive disorder (OCD) in patients who are refractory to selective serotonin reuptake inhibitors (SSRIs) 2, 3, 4, 5.
• Studies have shown that aripiprazole augmentation can be effective in reducing symptoms of OCD, with significant improvements in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores 3, 4, 5.
• Aripiprazole has been compared to other antipsychotics, such as quetiapine, and has been found to be effective and well-tolerated as an augmentative treatment for SSRI-refractory OCD 4.
• The efficacy and safety of aripiprazole augmentation have been demonstrated in several studies, including a systematic review and meta-analysis, which found that aripiprazole was superior to placebo in reducing OCD symptoms 3.
• Aripiprazole has also been found to be effective in treating comorbid bipolar disorder and OCD, with significant improvements in both affective and obsessive-compulsive symptoms 2.

Dosage and Administration

• The dosage of aripiprazole used in studies for OCD has varied, but typical doses range from 10-15 mg/day 2, 5.
• Aripiprazole can be added to ongoing SSRI treatment, and the combination has been found to be effective in reducing OCD symptoms 3, 4, 5.

Safety and Tolerability

• Aripiprazole has been found to be generally safe and well-tolerated as an augmentative treatment for OCD, with few adverse events reported 2, 4, 5.
• However, as with any medication, there is a risk of side effects, and patients should be monitored closely for any adverse reactions 4.