Treatment of Hypochondriasis in Two Schizophrenia PatientsUsing Clozapine

Hypochondriasis (HYPO), an obsessive-compulsive spectrum disorder, is frequent in patients with schizophrenia (SCH) (20%),especially among those treated with clozapine (36.7%). Treatment options for OCS/OCD in patients under clozapine (CLZ) includecombining clozapine with amisulpride/aripiprazole or a mood stabilizer, augmenting clozapine with a serotoninergic reuptakeinhibitor, adding cognitive behavioural therapy, and gradually reducing dosage. No treatments have been proposed for HYPO inpatients using clozapine so we examine these options in 2 cases and report the results. Among treatments delivered, only dosagereduction adequately worked. We recommend caution when thinking about escalating treatment and suggest trying it only whenalternative interventions were not successful and weighing risk and benefits of this therapeutic strategy. Further research is neededto confirm the hypothesis that CLZ treatment induces hypochondriac symptoms, to investigate the prevalence of the phenomenon,and, mostly, to identify possible treatment strategies.