Category Archives: Obsessive-Compulsive Disorder

Pharmacologic Treatment in Children and Adolescents for OCD

Clomipramine (Anafranil) Clomipramine (Anafranil), a tricyclic antidepressant (TCA) and potent serotonin re-uptake inhibitor, was used in the first controlled pharmacologic treatment trial in children and adolescents for OCD. Nineteen pediatric patients (mean age, 14.5 ± 2.3 years) were studied in a 12-week double-blind placebo-controlled crossover study (5 weeks of active medication) (). Doses of clomipramine… Read More »

Uses of Sertraline for OCD

Use in Children and Adolescents Sertraline has been shown to be effective and generally well tolerated in children and adolescents with obsessive-compulsive disorder (). In the largest study of sertraline in pediatric obsessive-compulsive disorder to date, the efficacy and safety of sertraline in children and adolescents were evaluated in a 12-week multicenter double-blind placebo-controlled trial… Read More »

Uses of Citalopram for OCD

Use in Children and Adolescents There have been some reports of efficacy of citalopram in children. Maud and Stein (1996) described one case of a prepubertal girl with obsessive-compulsive disorder who responded to 40 mg citalopram within 10 weeks and remained well for an additional 3 months thereafter. More significant is an open-label trial of… Read More »

Doses of Citalopram for OCD

Most patients easily tolerate an initial dose of 20 mg, administered once daily. This dose can be taken in the morning or at night depending on the individual’s side effect profile, because some patients may develop insomnia or other sleep disturbance in contrast to the more commonly reported somnolence. It is not necessary to take… Read More »

Doses of Sertraline for OCD

A 12-week dose-ranging study in 324 patients () established the minimum clinically effective dose of sertraline to be 50 mg/day. Patients in this study were randomly assigned to sertraline doses of 50 mg/day, 100 mg/day, or 200 mg/day or to placebo. There were no significant differences in efficacy between the three sertraline groups, each of… Read More »

Doses of Fluoxetine for OCD

The optimal antiobsessive dose range of fluoxetine remains controversial. Doses between 20-80 mg/day of fluoxetine have been used in both open and controlled studies in patients with OCD. As noted earlier, two multi-center fixed-dose studies in obsessive-compulsive disorder have been performed, one in the United States and one in Europe. In the U.S. study performed… Read More »

Clomipramine: Treatment Duration and Discontinuation

Because of the considerable time lag that can exist (6-10 weeks) between initial dosing and onset of significant improvement, patients will need a lot of encouragement to remain compliant with their treatment regimen. Because side effects often appear before any clinical improvement, patients are prone to early discouragement with clomipramine. Often, simply talking with them… Read More »

Doses of Clomipramine for OCD

Prescribing clomipramine (trademarked as Anafranil and Clofranil) for patients with obsessive-compulsive disorder requires consideration of not only the nature of the drug but also the nature of the disorder. On the one hand, it has been our clinical experience that patients with obsessive-compulsive disorder are incredibly tolerant of side effects (see case examples at the… Read More »