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Long-Term Sertraline Effective in Treating Obsessive-Compulsive Disorder in Children and Adolescents

Sertraline appears to be effective for treating children and teens with obsessive-compulsive disorder (OCD). About half of these patients achieve remission and improved function after an initial acute response, according to new research.

Long-term treatment with sertraline may maintain and enhance the initial improvement achieved during acute therapy and might also prevent relapse, according to the researchers. The efficacy of this agent as an acute treatment for OCD has been demonstrated in children and adolescents, but few studies have evaluated the effectiveness of long-term treatment for OCD in this population.

Karen Dineen Wagner, MD, Division of Child and Adolescent Psychiatry, University of Texas Medical Branch, Galveston, United States, and colleagues evaluated the remission rate among 72 children 6 to 12 years old and 65 adolescents 13 to 18 years old.

All participants had been diagnosed with OCD and had completed a 12-week, double-blind, placebo-controlled sertraline study. In the current study, participants received open-label sertraline, at a dose of 50-200 mg for 52 weeks.

A Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) score of 8 or less defined full remission, and partial remission was defined as a CY-BOCS score of 15 or less.

Nearly half (47%) of patients achieved full remission, and 25% achieved partial remission. Among those who completed the study, 55% achieved full remission, and 31% achieved partial remission. Children were more likely to achieve full remission than adolescents.

"Although these results are impressive in light of the chronicity and severity of the illness," only about half of patients achieved full remission, Dr. Wagner and colleagues write. "If clinical response is an appropriate goal for acute treatment of OCD, full remission should be the goal of long-term treatment.".

"More research is needed to develop pharmacologic and psychotherapeutic strategies that facilitate the achievement of full remission in the remaining patients suffering from this chronic and disabling illness," they suggest.
J Child Adolesc Psychopharmacol 2003;13:Suppl 1:S53-60. "Remission status after long-term sertraline treatment of pediatric obsessive-compulsive disorder"

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