Thomsen P H
Psychiatric Hospital for Children and Adolescents, University Hospital of Aarhus, Denmark.
Eur Child Adolesc Psychiatry. 2000;9 Suppl 1:I76-84. doi: 10.1007/s007870070021.
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.
儿童和青少年强迫症（OCD）通常是一种致残性疾病，需要药物治疗。研究表明，血清素与该疾病有关，经验性治疗研究表明，具有血清素活性的抗抑郁药是有效的。儿童和青少年强迫症心理药物治疗的首选是SSRI类药物，这类药物在儿童和青少年中已被证明有效且耐受性良好。到目前为止，记录最完善的SSRI是舍曲林。然而，氟西汀和氟伏沙明也在儿童和青少年中进行了系统研究。氯米帕明已被证明有效，然而，该药物引起的副作用表明SSRI是更好的选择。使用SSRI治疗似乎对约75%的强迫症患者有效。目前仍没有系统研究分析用于患有强迫症的儿童和青少年的增效药物。研究表明，在大多数情况下，药物治疗和心理治疗（认知行为疗法）相结合很重要。基于对患有强迫症的儿童和青少年的一些长期随访研究，没有证据表明所有儿童和青少年都会患终身性疾病。因此，建议在成功治疗1 - 1.5年后尝试停药。
