title: Clonazepam as an augmenting agent in the treatment of childhood-onset obsessive-compulsive disorder.
abstract: 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.
authors.affiliation: Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.
authors.forename: H L
authors.initials: HL
authors.lastname: Leonard
authors.forename: D
authors.initials: D
authors.lastname: Topol
authors.forename: O
authors.initials: O
authors.lastname: Bukstein
authors.forename: D
authors.initials: D
authors.lastname: Hindmarsh
authors.forename: A J
authors.initials: AJ
authors.lastname: Allen
authors.forename: S E
authors.initials: SE
authors.lastname: Swedo
mesh_terms: D000293:Adolescent; D002997:Clomipramine / Q000378:metabolism / Q000627:therapeutic use; D002998:Clonazepam / Q000008:administration & dosage* / Q000494:pharmacology* / Q000627:therapeutic use; D003975:Diazepam / Q000378:metabolism / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004357:Drug Synergism; D005473:Fluoxetine / Q000378:metabolism / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000523:psychology; D017367:Selective Serotonin Reuptake Inhibitors / Q000378:metabolism* / Q000627:therapeutic use; D013406:Suicide, Attempted; D013881:Thioridazine / Q000378:metabolism / Q000627:therapeutic use
chemical_list: D002997:Clomipramine; D002998:Clonazepam; D003975:Diazepam; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors; D013881:Thioridazine