Zoloft in Children and Teens With OCD

Serotonin reuptake inhibitors are the treatment of choice for individuals with obsessive-compulsive disorder (OCD); however, empirical support for this assertion has been weaker for children and adolescents than for adults.

This study was designed to evaluate the safety and efficacy of the selective serotonin reuptake inhibitor sertraline hydrochloride (Zoloft) in children and adolescents with obsessive-compulsive disorder (randomized, double-blind, placebo-controlled trial).

One hundred eighty-seven patients (107 children aged 6 to 12 years and 80 adolescents aged 13 to 17 years) were randomized to receive either sertraline (53 children, 39 adolescents) or placebo (54 children, 41 adolescents).

Sertraline hydrochloride was titrated to a maximum of 200 mg/d during the first four weeks of double-blind therapy, after which patients continued to receive this dosage of medication for eight more weeks. Control patients received placebo.

Assessment instruments included: the Childrenšs Yale-Brown Obsessive Compulsive Scale, the National Institute of Mental Health Global Obsessive Compulsive Scale, and the NIMH Clinical Global Impressions of Severity of Illness.

Patients treated with sertraline showed significantly greater improvement than did placebo-treated patients. Differences in efficacy between sertraline and placebo emerged at week 3 and persisted for the duration of the study. Based on ratings at end point, 42% of patients receiving sertraline and 26% of patients receiving placebo were very much or much improved. Neither age nor sex predicted response to treatment. The incidence of side effects (insomnia, nausea, agitation, and tremor)were significantly greater in patients receiving sertraline.

(March J. Sertraline in children and adolescents with obsessive-compulsive disorder. JAMA 1998; 280(20):1752-1756)

COMMENT: Sertraline appears to be a safe and effective short-term treatment for children and adolescents with obsessive-compulsive disorder.