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Clozapine is not recommended for OCD due to poor evidence of efficacy [170]. In addition, several case reports and clinical studies support the association of clozapine with worsening or onset of obsessive-compulsive symptoms in patients with a psychotic disorder [171-176]. At least 20% of individuals treated with clozapine (and other antiserotonergic antipsychotics) would experience worsening or emergence of obsessive-compulsive symptoms [177], which are dose-related [178] and generally reversible upon discontinuation of clozapine treatment and switch to a different antipsychotic [179]
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