Clonazepam as an augmenting agent in the treatment of childhood-onset obsessive-compulsive disorder.
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.
Leonard
H L
HL
Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.
Topol
D
D
Bukstein
O
O
Hindmarsh
D
D
Allen
A J
AJ
Swedo
S E
SE
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
D002997:Clomipramine; D002998:Clonazepam; D003975:Diazepam; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors; D013881:Thioridazine