Scrupulosity
Little evidence is available on the use of medications to treat scrupulosity. Although serotonergic medications are often used to treat OCD, studies of pharmacologic treatment of scrupulosity in particular have produced so few results that even tentative recommendations cannot be made.
Mixed affective state
Treatment of mixed states is typically based upon administration of mood stabilizing medication, which may include anticonvulsants such as valproic acid; atypical antipsychotics such as olanzapine, aripiprazole, and ziprasidone; or first-generation antipsychotics such as haloperidol. There is question of lithium's efficacy for treatment of mixed states due to conflicting conclusions drawn from various trials and research. Mood stabilizers work to reduce the manic symptoms associated with the mixed state, but they are not considered particularly effective for improving concurrent depressive symptoms.