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| |  Sertraline Found Safe And Effective For Obsessive-Compulsive Disorder In Children CHICAGO, IL -- Nov. 24, 1998 -- Sertraline hydrochloride is safe and effective short-term treatment for children and adolescents with obsessive-compulsive disorder (OCD), according to an article in tomorrow’s issue of The Journal of the American Medical Association. John March, M.D., M.P.H., of Duke University Medical Center in Durham, N.C., and colleagues studied 187 children and adolescents (107 children between ages of six and 12 and 80 adolescents between the ages 13 and 17) over 12 weeks to evaluate the safety and effectiveness of sertraline hydrochloride, a selective serotonin reuptake inhibitor (SSRI), in treating children and adolescents with diagnosed OCD. Controlled studies of sertraline use in adults with OCD have demonstrated that it is effective in doses of 50 to 200 mg, but this is the first study to the authors' knowledge to examine the safety and effectiveness of the drug in children with OCD. The researchers found that the sertraline-treated patients exhibited significantly greater improvement than placebo-treated patients. The researchers used four tests that measure the severity of OCD symptoms to determine effectiveness of therapy. Children and adolescents treated with sertraline showed greater improvement of their OCD symptoms than those treated with placebo on three of the four measures. Significant differences between the sertraline and placebo groups emerged after three weeks of therapy and persisted for the duration of the study. The treatment did not have any adverse impact on vital signs, laboratory tests or electrocardiographic tests of the children taking sertraline. Fifty-three percent of sertraline patients decreased and improved their score by at least 25 percent on one of the tests, compared to 37 percent of placebo patients who decreased their score by that much. Also, 42 percent of sertraline patients had a rating of very much or much improved on another test at the end of the study, compared with 26 percent of placebo patients who had that score. The authors report that 13 percent of sertraline subjects and 3.2 percent of placebo subjects discontinued treatment because of adverse reactions. Adverse reactions, such as insomnia, nausea, agitation and tremor, were more common in patients receiving sertraline than placebo patients. However, the authors report that the great majority of adverse experiences fell in the mild-to-moderate range. "Although treatment with sertraline provided clinically meaningful benefits, as in other studies of [seratonin reuptake inhibitors] in OCD, the average sertraline-treated patient remained in the mildly ill range on [one of the tests] at the end of treatment,” they write. “Accordingly, most experts agree that the probability of clinical normalisation is enhanced by combining [drug therapy] with OCD-specific cognitive-behavioural psychotherapy. "Although current treatments are not generally curative, given a correct diagnosis and skilful treatment most children and adolescents with OCD will improve considerably." Approximately one in 200 young people suffer from obsessive-compulsive disorder, which results in the person having recurrent and persistent thoughts, images or impulses that are intrusive and acknowledged as senseless. Common obsessions are generally accompanied by distressing negative emotions, such as fears or hoarding urges, that people with OCD try to ignore, suppress or neutralise through repeated behaviours or actions. Compulsions can be observable behaviours, such as hand washing, or mental acts, such as counting. Few children and adolescents with OCD are correctly diagnosed and even fewer receive appropriate treatment.
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