Reply to Letter to the Editor "Risperidone May Worsen Fluoxetine-Treated OCD"

Sir: We read with interest the letter by Dr. Andrade describing a patient with SRI-refractory OCD whose symptoms were exacerbated after adjunctive risperidone was added to ongoing fluoxetine treatment. We urge caution, however, in making any conclusions about the efficacy or tolerability of risperidone augmentation of SRI treatment based on the reactions of a single patient. In addition to our study of risperidone augmentation in 26 SRI-refractory OCD patients, several other reports describe the therapeutic value of adding risperidone to an SRI or clomipramine for refractory OCD as well as related OCD-spectrum disorders, such as trichotillomania and Tourette’s syndrome.