Although antipsychotics are commonly employed in treatment augmentation strategies for severe obsessive-compulsive disorder (OCD) among adolescents, the role of atypical neuroleptics is still unclear (1.2.). Since our clinical practice suggest that in some cases small amount of olanzapine was helpful for patient with resistance to SSRI mono therapy (specially added to fluvoxamine mono therapy) we tested the hypothesis that olanzapine augmentation would be beneficial in treatment-unresponsive OCD.

8-week trial, we recruited 11 adolescents (mean age 14,7) with OCD (DSM-IV criteria), unresponsive to Fluvoxamine (≥100mg/day) for ≥ 10 weeks, which was continued throughout the trial. Subjects had OCD for ≥ 2 year, a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score typically was of ≥ 18, and no other primary Axis I disorder is exist. After 10 week Fluvoxamine therapy Olanzapine was added in minimal therapeutic amount of 2,5mg daily. After 6 week combination therapy the symptoms was evaluated by Y-BOCS.

Preliminary analyses of data of these patients demonstrate a statistically and clinically significant improvement in OCD symptoms (50%–60% mean improvement in general, Y-BOCS scores dropped 68%, 30%, and 30%,). Combo treatment for adolescents was well tolerated and safety.