1999- 2007: OCD: ADHD: Childhood Bipolar Disorder: The Evolution of a Diagnosis ; part 5

2003

Impact of Comorbidity on Treatment Response to Paroxetine in Pediatric Obsessive-Compulsive Disorder: Is the Use of Exclusion Criteria Empirically Supported in Randomized Clinical Trials?-Biederman 2003

This paper was cited by:

Sequential cognitive-behavioral therapy for children with obsessive–compulsive disorder with an inadequate medication response: a case series of five patients

Eric A. Storch, Daniel M. Bagner, Gary R. Geffken, Jennifer W. Adkins, Tanya K. Murphy, Wayne K. Goodman
Depression and Anxiety. 2006

Cross Ref /current/OCD Gov. trial CBT vs.Zoloft Storch/Goodman.

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This new study has changed it's primary goal to prove CBT gold standard treatment of OCD vs. Zoloft. I spoke in length to Storch months ago, and since then the study has changed.Though it appears CBT will still be part of the study, it seems to have broadened. It is one to be watched, it is acknowledging "activation syndrome" and SSRI's in kids/teens. Exactly what I discussed with him on the phone about my daughter's negative Zoloft experience. Zoloft had been given to her, for the OCD switch to Bipolar dx. It will be interesting to see how it turns out if the study ever gets started.

SSRI-Induced Activation Syndrome in Pediatric Obsessive Compulsive Disorder,Zoloft vs.CBT for OCD

"This proposal has two parts.

In part one we will be developing and evaluating a new behavioral test to measure certain side effects (such as increased anxiety, impulsivity, and manic behavior) often linked to antidepressant use in children.

In part two we will examine these side effects in a clinical trial of the FDA-approved medication sertraline in subjects with pediatric Obsessive-Compulsive Disorder (OCD). In addition, all participants will receive Cognitive Behavioral Therapy (CBT), starting at Visit 4. CBT includes education, training, and identifying the repetitive behaviors that participants engage in and upsetting thoughts that they have, and teaching them ways of responding to them in a positive manner." -2007

"A recent FDA re-analysis of clinical trials of children with psychiatric conditions found that the risk of suicidal ideation and behavior was considerably higher with antidepressants than placebo. These data revealed that suicidality was not limited to depression: subjects with OCD and other anxiety disorders also showed this higher risk. Although the process responsible for this effect is unknown, initiation of an “activation syndrome” (e.g., irritability, restlessness, emotional lability, etc.) may represent a change that promotes suicidality. SSRI-induced activation syndrome is well-accepted by clinicians and thought to be common, particularly in children and teens. However, there is a shortage of empirical data on this syndrome. We see activation syndrome as an adverse event that occurs relatively independent of the diagnosis, while acknowledging that various factors may change susceptibility and expression (e.g., age, dosing, etc.).

* Better characterization of activation syndrome and its timing might point to the mechanisms mediating this adverse effect as well as approaches to its reduction."