SSRIs vs SNRIs in Pediatric Anxiety Disorders: Which Are More Tolerable?

Topics: Anxiety | efficacy | Obsessive Compulsive Disorder | OCD | Serotonin Norepinephine Reuptake Inhibitors | Serotonin Specific Reuptake Inhibitors | Side Effects | SNRIs | SSRIs

REVIEW OF: Mills JA and Strawn JR, J Am Acad Child Adolesc Psychiatry 2020;59(11):1240–1251 STUDY Type: Meta-analysis For children with anxiety disorders and OCD, SSRIs produce faster and greater improvement than SNRIs (Strawn JR et al, J Am Acad Child Adolesc Psychiatry 2018;57(4):235–244.e2). Unfortunately, adverse effects slow down our dose

Quetiapine in Bipolar With OCD

Topics: Antipsychotics | Bipolar Disorder | Co-occurring disorders | Obsessive Compulsive Disorder | OCD | Quetiapine

REVIEW OF: Sahraian A et al, CNS Spectr 2021;1–5 TYPE OF STUDY: Randomized, double-blind, placebo-controlled clinical trial SSRIs are first-line meds for obsessive-compulsive disorder (OCD), but they may pose risks of mania and rapid cycling when the patient also has bipolar disorder (BD). These conditions overlap more often than expected by chance,

The Schizophrenia-OCD Overlap

Topics: Antipsychotics | Aripiprazole | Clozapine | Comorbidity | Diagnosis | Lamictal | Lamotrigine | Obsessive Compulsive Disorder | OCD | olanzapine | Pharmacology Tips | polypharmacy | Quetiapine | Risperidone | Schizoaffective disorder | Schizophrenia

TCPR: What is schizo-obsessive disorder?Dr. Poyurovsky: Schizo-obsessive disorder (schizo-OCD) is not a DSM diagnosis. The term is used to refer to patients with schizophrenic disorders that have comorbid features of OCD. We see these obsessive-compulsive symptoms in schizophrenia more often than would be expected by chance. About one in four patients h

How to Use Lamotrigine

Topics: Bipolar Depression | Bipolar Disorder | Bipolar II | Borderline Personality Disorder | BPD | Hypomania | Lamictal | Lamotrigine | Medication | Mood Stabilizers | OCD | Pharmacology | Psychopharmacology

Lamotrigine is FDA approved as maintenance treatment for bipolar disorder—that is, for delaying episodes of depression, hypomania, or mania. However, it is not approved for active depression or mania—which has given it a reputation as a “light” mood stabilizer. For patients who appreciate tolerability, that’s a good thing, but it isn’t the f

New Augmentation Strategies in OCD

Topics: Amphetamines | Novel Medications | OCD | Pharmacology

Review of: Naderi S, Psychiatry Clin Neurosci 2019;73(4):169–174 and Zheng H et al, Eur Neuropsychopharmacol 2019;29(3):397–404 Study types: Positive RCTs Serotonergic agents—both SSRIs and clomipramine—have historically been the cornerstone of pharmacotherapy for OCD. However, response rates are notoriously low, and few patients achieve full

Azithromycin for Acute-Onset Obsessive-Compulsive Disorder in Children

Topics: Child Psychiatry | OCD | Research Update

Review of: Murphy et al, J Child Adolesc Psychopharmacol 2017; 27(7):640–651 Pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric syndrome associated with streptococcus (PANDAS) have been the subject of many debates in the field. From obsessions, compulsions, and tics, to personality changes and opposi

Celecoxib as Adjunctive Treatment in Acute Mania

Topics: Bipolar Disorder | Child Psychiatry | OCD | Research Update

Review of: Mousavi et al, J Child Adolesc Psychopharmacol 2017; 27(6):494–500 Emotional stress can trigger an inflammatory cascade response and increase blood levels of proinflammatory cytokines—including IL-1, IL-6, and tumor necrosis factor (TNF-α). These same inflammatory markers intensify in acute episodes of depression and mania. So, would

Does Guanfacine Affect Tic Severity in Children With Chronic Tic Disorders?

Topics: OCD | Research Updates

Review Of: Murphy TK et al, J Child Adolesc Psychopharmacol 2017;20(20):1–9 Tic disorders, including Tourette’s, often co-occur with ADHD, OCD, and anxiety disorders. Guanfacine is often tried for all of these conditions. Randomized placebo-controlled trials of immediate release guanfacine have been mixed, with one showing 31% improvement in tics

PANDAS/PANS: A Constellation of Symptoms Searches for a Cause

Topics: Child Psychiatry | OCD

In the 1990s, investigators at the National Institute of Mental Health (NIMH), including pediatrician Susan Swedo, MD, were conducting studies on OCD in childhood and observed that some children had a very sudden onset of symptoms rather than the typical gradual increase in OCD behavior. The appearance of the symptoms was abrupt and intense enough (reac

Diagnosing and Treating PANDAS/PANS: A View From the Clinic

Topics: ADHD | Child Psychiatry | OCD

CCPR: Dr. Greenberg, thanks for returning to CCPR. You gave great information in our March issue on Tourette’s disorder, and we know you also treat kids with PANDAS/PANS. How many kids have you seen with PANDAS/PANS? Dr. Greenberg: I devote one day a week to patients with PANDAS/PANS, and I see one to two new cases a week. I’ve probably seen 50�

Take The CME Post-Test for PANDAS, PANS, and Related Disorders, CCPR, June/July 2017

Topics: ADHD | Child Psychiatry | OCD

The post-test for this issue is available for one year after the publication date to subscribers only (December 31, 2017). By successfully completing the test you will be awarded a certificate for 2 CME credits. Click here to take your CME test. Note: All of the CME tests are available in the “My Account” section of the site when you are logg

Treating Tourette’s Disorder

Topics: Child Psychiatry | OCD | Practice Tools and Tips | Psychotherapy

David was a 12-year-old boy referred for consultation by his child psychiatrist for help in managing his severe Tourette’s disorder. David had developed onset of eye blinking at age 6 in the context of problems paying attention in his first-grade classroom. He tended to call out answers and wasn’t completing tests or his homework. By age 8, he had d

Assessing and Diagnosing Tic Disorders

Topics: Child Psychiatry | OCD | Practice Tools and Tips

CCPR: Would you describe your clinical work in tic disorders and how that operates? I think readers will want to know about the number of patients you see and how the clinic is structured. Dr. Greenberg: I work in the obsessive compulsive disorder (OCD) and related disorders program, and I see both kids with tics and OCD or OCD-related disorders as w

Internet-Delivered CBT for Adolescents With OCD

Topics: Child Psychiatry | OCD | Research Update

Study Reviewed: Lenhard F et al. Therapist-guided, Internet-delivered cognitive-behavioral therapy for adolescents with obsessive-compulsive disorder: A randomized controlled trial. J Am Acad Child Adolesc Psychiatry 2017;56(1):10–19. doi:10.1016/j.jaac.2016.09.515 Study Type: Randomized controlled trial The prevalence of obsessive-compulsive di

SSRIs May Work More Quickly in Pediatric OCD Than You Realize

Topics: OCD | Psychopharmacology Tips | Research Updates

Review of: Varigonda A et al. Journal of the American Academy of Child & Adolescent Psychiatry 2016; ahead of publication. STUDY TYPE: Systematic literature review and meta-analysis The pharmacological treatment of obsessive-compulsive disorder (OCD) for adults is pretty well worked out. Selective serotonin reuptake inhibitors (SSRIs) are the

N-acetylcysteine Shows Promise for Skin-Picking Disorder

Topics: OCD | Research Updates

N-acetylcysteine Shows Promise for Skin-Picking Disorder

Topics: OCD | Research Update

Subject: (Grant J et al, JAMA Psychiatry, 2016;73:490–496) Short Description: Excoriation, or what’s often referred to as skin-picking disorder (SPD), is a distressing and disfiguring behavior that affects up to 5% of people, occurring more commonly in women. Various lines of evidence imply that this compulsive behavior may be related to reduce

Kids and Anxiety Disorders

Topics: Anxiety Disorder | Child Psychiatry | Cognitive Behavioral Therapy | OCD | Practice Tools and Tips

OCD in Kids: CBT, SSRIs, Then What?

Topics: Child Psychiatry | Cognitive Behavioral Therapy | Free Articles | OCD | Research Updates

Internet-Based Therapy Helps Patients with OCD

Topics: OCD | Research Updates