Successful Treatment Response with Aripiprazole Augmentation of SSRIs in Refractory Obsessive-Compulsive Disorder in Childhood

摘要

The aim of this study is to evaluate the aripiprazole augmentation of selective seratonine reuptake inhibitors (SSRIs) in children and adolescents with treatment-resistant OCD. Forty-eight children and adolescents (14 girls, 34 boys), who are non-responders to treatment with at least two types of SSRIs and CBT, were administered a 12-week of augmentation. Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and Clinical Global Impression-Severity and Improvement (CGI-S and CGI-I) sub-scales were used for evaluation of the treatment outcomes. The results showed that total CY-BOCS scores were decreased from 33.3 +/- 7.5 to 11.7 +/- 9.3 (p < 0.001), CGI-S scores decreased from 6.3 +/- 0.9 to 2.7 +/- 1.6 (p < 0.001), and CGI-I scores improved from 4.3 +/- 0.6 to 2.2 +/- 1.1 (p < 0.001). Sensitivity analyses in 29 patients without SSRI dose escalation along with aripiprazole augmentation have also revealed that improvement effect was still significant, and CY-BOCS scores were improved from 34.2 +/- 7.9 to 13 +/- 10.3, CGI-S improved from 6.4 +/- 1.0 to 3.0 +/- 1.7, and CGI-I improved from 4.4 +/- 1.0 to 2.3 +/- 1.1 (p < 0.001 for all). Analyses revealed that a significant clinical improvement has been observed with aripiprazole augmentation. Aripiprazole augmentation of SSRIs is a promising strategy in the management of treatment-refractory OCD children and adolescents.