Obsessive-complusive disorder: pharmacological treatment.

Abstract

Obsessive-compulsive disorder (OCD) in children and adolescents is often a disabling condition, which demands treatment with medication. Research shows that serotonin is involved in the disorder and empirical treatment studies show that antidepressants with serotonin activity are effective. The first choice of treatment in the psychopharmacological approach to OCD in children and adolescents are the SSRI agents, which have been documented as being effective as well as well-tolerated in children and adolescents. The best-documented SSRI to this point is sertraline. However, fluoxetine and fluoxamine have also undergone systematic studies in children and adolescents. Clomipramine has been proven effective, however, side effects caused by this agent would suggest that an SSRI is a better choice. Treatment with an SSRI seems to have effect in approximately 75 % of patients with OCD. There are still no systematic studies analyzing augmenting medication for children and adolescents with OCD. Research indicates that the combination of medication and psychotherapy (cognitive behavioural therapy) is important in most cases. Based on a few long-term follow-up studies on OCD children and adolescents there is not evidence that all children and adolescents suffer a lifetime course of the disease. It is therefore recommended that discontinuation is attempted after 1-1.5 years of successful treatment.