A 34-year-old, Caucasian, male patient with a diagnosis of paranoid schizophrenia for 14 years was admitted for psychiatric examination with complaints of repeating some words and washing hands frequently. He was on clozapine 100 mg/day treatment for 2 years. He was hospitalized due to exacerbation of psychotic and OCS.\nA 10-mg/day dose of aripiprazole was added on to his ongoing 100-mg/day clozapine treatment. At the end of the first week, clozapine dose increased to 150 mg/day and aripiprazole dose to 30 mg/day gradually. The plasma clozapine and norclozapine levels were over therapeutic level as 746.1 and 519.1 ng/mL at the end of the third week, so clozapine dose decreased to 100 mg/day. The clozapine andaripiprazole doses, plasma drug levels, and the clinical rating scale scores are given at Table \n. During discharge, his scores of PANSS was 50 (141 at admission), BPRS was 20 (74 at admission), and YBOCS was 20 (40 at admission).
A 28-year-old, Caucasian, male patient, with a diagnosis of residual schizophrenia, treated for 2 years with clozapine 100 mg/day was admitted because of the worsening of his psychotic symptoms. His OCS first was seen at age of 13. He had control and symmetry obsessions and compulsions. After 5 years of OCS, he had psychotic symptoms. He reported that he could not leave the house for the last 2 years, due to his persecution delusions, skepticism, and resentment. He was on a treatment of clozapine 100 mg/day for 2 years.\nHe was hospitalized with a dose of 10 mg/day aripiprazole added on to his ongoing 100-mg/day clozapine treatment. The plasma level of clozapine and norclozapine were lower than therapeutic level at the admission. At the end of the second week, clozapine dose increased to 200 mg/day and aripiprazole to 30 mg/day gradually. The clozapine, norclozapine, aripiprazole doses and the clinical rating scale scores are given at Table \n. During discharge, his scores of PANSS was 49 (78 at admission), BPRS was 27 (39 at admission), and Y-BOCS was 15 (40 at admission).