Early-term Aripiprazole Augmentation and Clinical Efficacy in Treatment of Pediatric OCD: A Case Series of Six Adolescents

Abstract

Obsessivecompulsive disorder (OCD) in childhood is characterized by intrusive thoughts and compulsions causing significant levels of distress and functional deterioration. Guidelines for OCD treatment recommend CognitiveBehavioral Therapy (CBT) as first line treatment choice, best efficient when practiced along with family counseling and psychoeducation. Selective serotonin Reuptake Inhibitors (SSRI) have long been successfully used in the treatment of OCD. Therapy with multiple drugs and augmentation strategies have only been proposed for cases with treatment resistance. The term “treatment-resistance” reflects presence of persistent and severe OCD symptoms even though efficient and recommended line of treatment strategies have been used at therapeutic doses for recommended period. This might indicate clinical unresponsiveness following the use of at least two different SSRIs or one SSRI and clomipramine, accompanied by sufficient number of CBT sessions. Many drugs have been tried for augmentation, in the face of treatment-resistance. However, such drug trials mainly have been conducted with adult samples, and studies that assess augmentation in children and adolescents have been scarce. Some of these have focused on aripiprazole as a fine alternative to be used for augmentation. This series comprises clinical course and treatment of six adolescents diagnosed with OCD from three different centers in Turkey, who had all responded well to early onaugmentation treatment with aripiprazole, indicating the possible need to further discuss the given issue.