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Purpose of review <p>The aim of this review is to summarize the current state of knowledge guiding evidence-based pharmacologic treatment of pediatric Obsessive Compulsive Disorder (OCD).</p> Recent findings <p>Cognitive-behavioral therapy incorporating exposure and response prevention (CBT-ERP) and selective serotonin reuptake inhibitors (SSRIs) remain the first-line treatments for OCD. However, even with optimal treatment, 40–60% of patients fail to achieve full remission, necessitating alternative treatment modalities. Clomipramine remains an effective alternative monotherapy or augmenting agent but carries the risk of increased side effects. Other augmentation strategies have been investigated, with the strongest evidence to date supporting low-dose atypical antipsychotics (risperidone, aripiprazole).</p> Summary <p>The past decade has brought insight into dose optimization, augmentation, and novel receptor targets, sparking renewed research interest and treatment guidelines. Nevertheless, first line treatment remains CBT-ERP with SSRIs, with augmentation options for treatment resistance.</p>

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Pharmacologic Treatment of Pediatric Obsessive-Compulsive Disorder: An Evidence-Based Narrative Review

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月3日

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  • Tarik Hadzic,
  • Aaron Lulla,
  • Erika L. Nurmi

摘要

Purpose of review

The aim of this review is to summarize the current state of knowledge guiding evidence-based pharmacologic treatment of pediatric Obsessive Compulsive Disorder (OCD).

Recent findings

Cognitive-behavioral therapy incorporating exposure and response prevention (CBT-ERP) and selective serotonin reuptake inhibitors (SSRIs) remain the first-line treatments for OCD. However, even with optimal treatment, 40–60% of patients fail to achieve full remission, necessitating alternative treatment modalities. Clomipramine remains an effective alternative monotherapy or augmenting agent but carries the risk of increased side effects. Other augmentation strategies have been investigated, with the strongest evidence to date supporting low-dose atypical antipsychotics (risperidone, aripiprazole).

Summary

The past decade has brought insight into dose optimization, augmentation, and novel receptor targets, sparking renewed research interest and treatment guidelines. Nevertheless, first line treatment remains CBT-ERP with SSRIs, with augmentation options for treatment resistance.