Cargando…
The Effectiveness of Selective Serotonin Reuptake Inhibitors for Treatment of Obsessive-Compulsive Disorder in Adolescents and Children: A Systematic Review and Meta-Analysis
Background: Obsessive-compulsive disorder (OCD) is a common behavioral disorder among adolescents and children. The selective serotonin reuptake inhibitors (SSRIs) are the first pharmacological choice for this condition due to mild adverse effect profile. Objective: This systematic review was perfor...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691487/ https://www.ncbi.nlm.nih.gov/pubmed/31447707 http://dx.doi.org/10.3389/fpsyt.2019.00523 |
_version_ | 1783443392324173824 |
---|---|
author | Kotapati, Vijaya Padma Khan, Ali M. Dar, Sara Begum, Gulshan Bachu, Ramya Adnan, Mahwish Zubair, Aarij Ahmed, Rizwan A. |
author_facet | Kotapati, Vijaya Padma Khan, Ali M. Dar, Sara Begum, Gulshan Bachu, Ramya Adnan, Mahwish Zubair, Aarij Ahmed, Rizwan A. |
author_sort | Kotapati, Vijaya Padma |
collection | PubMed |
description | Background: Obsessive-compulsive disorder (OCD) is a common behavioral disorder among adolescents and children. The selective serotonin reuptake inhibitors (SSRIs) are the first pharmacological choice for this condition due to mild adverse effect profile. Objective: This systematic review was performed to evaluate the efficacy of SSRI for OCD in adolescents and children. Methods: Search terms were entered into PubMed, PsycINFO, Scopus, CINAHL, and Google Scholar. The included studies were randomized, placebo-controlled trials of SSRIs conducted in populations of children and adolescents younger than 18 years. Change from baseline Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), end-treatment CY-BOCS with respective SD, and response and remission rates were collected for continuous and dichotomous outcome assessment, respectively. Cochrane Rev Man software was used for meta-analyses, providing Forest plots where applicable. Results: SSRIs were superior to placebo with a small effect size. There was no additional benefit of combination treatment over cognitive behavioral therapy (CBT) alone, but CBT added substantial benefit to SSRI monotherapy. Fluoxetine and sertraline appear to be superior to fluvoxamine. Conclusion: The results of current systematic review and meta-analysis support the existing National Institute for Health and Care Excellence (NICE) guidelines for choosing CBT as first line of treatment and substituting it with SSRI, depending on patient preference. Adding CBT to current SSRI treatment is effective for non-responders and partial responders, but adding SSRI to ongoing CBT does not prove beneficial. The SSRIs have different effectiveness, and their relative efficacy remains to be investigated. |
format | Online Article Text |
id | pubmed-6691487 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-66914872019-08-23 The Effectiveness of Selective Serotonin Reuptake Inhibitors for Treatment of Obsessive-Compulsive Disorder in Adolescents and Children: A Systematic Review and Meta-Analysis Kotapati, Vijaya Padma Khan, Ali M. Dar, Sara Begum, Gulshan Bachu, Ramya Adnan, Mahwish Zubair, Aarij Ahmed, Rizwan A. Front Psychiatry Psychiatry Background: Obsessive-compulsive disorder (OCD) is a common behavioral disorder among adolescents and children. The selective serotonin reuptake inhibitors (SSRIs) are the first pharmacological choice for this condition due to mild adverse effect profile. Objective: This systematic review was performed to evaluate the efficacy of SSRI for OCD in adolescents and children. Methods: Search terms were entered into PubMed, PsycINFO, Scopus, CINAHL, and Google Scholar. The included studies were randomized, placebo-controlled trials of SSRIs conducted in populations of children and adolescents younger than 18 years. Change from baseline Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), end-treatment CY-BOCS with respective SD, and response and remission rates were collected for continuous and dichotomous outcome assessment, respectively. Cochrane Rev Man software was used for meta-analyses, providing Forest plots where applicable. Results: SSRIs were superior to placebo with a small effect size. There was no additional benefit of combination treatment over cognitive behavioral therapy (CBT) alone, but CBT added substantial benefit to SSRI monotherapy. Fluoxetine and sertraline appear to be superior to fluvoxamine. Conclusion: The results of current systematic review and meta-analysis support the existing National Institute for Health and Care Excellence (NICE) guidelines for choosing CBT as first line of treatment and substituting it with SSRI, depending on patient preference. Adding CBT to current SSRI treatment is effective for non-responders and partial responders, but adding SSRI to ongoing CBT does not prove beneficial. The SSRIs have different effectiveness, and their relative efficacy remains to be investigated. Frontiers Media S.A. 2019-08-06 /pmc/articles/PMC6691487/ /pubmed/31447707 http://dx.doi.org/10.3389/fpsyt.2019.00523 Text en Copyright © 2019 Kotapati, Khan, Dar, Begum, Bachu, Adnan, Zubair and Ahmed http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Psychiatry Kotapati, Vijaya Padma Khan, Ali M. Dar, Sara Begum, Gulshan Bachu, Ramya Adnan, Mahwish Zubair, Aarij Ahmed, Rizwan A. The Effectiveness of Selective Serotonin Reuptake Inhibitors for Treatment of Obsessive-Compulsive Disorder in Adolescents and Children: A Systematic Review and Meta-Analysis |
title | The Effectiveness of Selective Serotonin Reuptake Inhibitors for Treatment of Obsessive-Compulsive Disorder in Adolescents and Children: A Systematic Review and Meta-Analysis |
title_full | The Effectiveness of Selective Serotonin Reuptake Inhibitors for Treatment of Obsessive-Compulsive Disorder in Adolescents and Children: A Systematic Review and Meta-Analysis |
title_fullStr | The Effectiveness of Selective Serotonin Reuptake Inhibitors for Treatment of Obsessive-Compulsive Disorder in Adolescents and Children: A Systematic Review and Meta-Analysis |
title_full_unstemmed | The Effectiveness of Selective Serotonin Reuptake Inhibitors for Treatment of Obsessive-Compulsive Disorder in Adolescents and Children: A Systematic Review and Meta-Analysis |
title_short | The Effectiveness of Selective Serotonin Reuptake Inhibitors for Treatment of Obsessive-Compulsive Disorder in Adolescents and Children: A Systematic Review and Meta-Analysis |
title_sort | effectiveness of selective serotonin reuptake inhibitors for treatment of obsessive-compulsive disorder in adolescents and children: a systematic review and meta-analysis |
topic | Psychiatry |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691487/ https://www.ncbi.nlm.nih.gov/pubmed/31447707 http://dx.doi.org/10.3389/fpsyt.2019.00523 |
work_keys_str_mv | AT kotapativijayapadma theeffectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT khanalim theeffectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT darsara theeffectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT begumgulshan theeffectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT bachuramya theeffectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT adnanmahwish theeffectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT zubairaarij theeffectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT ahmedrizwana theeffectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT kotapativijayapadma effectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT khanalim effectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT darsara effectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT begumgulshan effectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT bachuramya effectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT adnanmahwish effectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT zubairaarij effectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis AT ahmedrizwana effectivenessofselectiveserotoninreuptakeinhibitorsfortreatmentofobsessivecompulsivedisorderinadolescentsandchildrenasystematicreviewandmetaanalysis |