The 5-HT2 receptor profiles of antipsychotics in the pathogenesis of obsessive-compulsive symptoms in schizophrenia.

Atypical antipsychotics have been reported to induce or exacerbate obsessive-compulsive symptoms (OCS) in patients with schizophrenia. We report the development of de novo obsession induced by sequential treatment with risperidone, aripiprazole, and ziprasidone, which have an antagonist effect on serotonin 5-HT(2A) receptors in a patient with schizophrenia. The obsession was repeatedly improved after switching the atypical antipsychotics to amisulpride, a selective D(2) and D(3) receptor antagonist. To our knowledge, this is the first report about ziprasidone-induced OCS in a patient with schizophrenia. In conclusion, this case supports the hypothesis that the antagonist effect on 5-HT(2) receptors may be related to atypical antipsychotic-induced OCS.