Leonard H L, Topol D, Bukstein O, Hindmarsh D, Allen A J, Swedo S E
Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.
J Am Acad Child Adolesc Psychiatry. 1994 Jul-Aug;33(6):792-4. doi: 10.1097/00004583-199407000-00003.
This case study is of a young man with childhood onset of severe obsessive-compulsive disorder (OCD). The patient had no clinical improvement during therapeutic trials of clomipramine, fluoxetine, and fluvoxamine, including buspirone augmentation. The patient consumed 50 tablets of fluoxetine in a suicide attempt and experienced a total remission of his OCD symptoms for the first time in his life. This remission lasted approximately 1 month and raises interesting questions about the mechanism of action of the serotonin reuptake inhibitors. Subsequently, the patient was able to achieve a 75% improvement in symptomatology when treated with a combination of fluoxetine and clonazepam. This open report suggests that clonazepam may be an effective augmentation agent to a serotonin reuptake inhibitor in the treatment of OCD.
