Abstract

Bipolar disorder with comorbid obsessive-compulsive disorder rates vary between 7 and 39%. Inversely, 15% of OCD patients present with BPD comorbidity. Serotonin reuptake inhibitors appear to be effective pharmacological treatment for OCD. However, in the case of comorbid BPD treatment with the ones poses the risk of treatment-emergent adverse events albeit concomitant mood-stabilizing treatment.
Little is known on the efficacy and safety of pharmacological intervention in BPD comorbid with OCD. No guidelines for the one exist.
The paper reports on a case of a BPD patient with comorbid OCD. He was in full remission of mood disorder with severe OCD on admission. He demonstrated a functional improvement of OCD symptoms in response to the addition of escitalopram (40mg) to divalproex along with behavioral intervention.
The case demonstrates efficacy and safety along with a good tolerance of the combination of divalproex and high doses of escitalopram in an OCD patient in course of the BPD.

Key words: obsessive compulsive disorder; bipolar disorder; escitalopram; divalproex; comorbidity