Long-Term Sertraline Treatment of Children and Adolescents With Obsessive-Compulsive Disorder

Cook, Edwin H.; Wagner, Karen Dineen; March, John S.; Biederman, Joseph; Landau, Phyllis; Wolkow, Robert; Messig, Michael

doi:10.1097/00004583-200110000-00011

Cited by 142 publications

(55 citation statements)

References 17 publications

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“…Several studies report that long-term treatment with SSRIs not only is well tolerated and effective at maintaining improvement but also results in continued improvement for up to 1 year (Cook et al, 2001;Thomsen et al, 2001). Treatment continued after this time appears to remain effective but does not result in further improvements.…”

Section: Obsessive-compulsive Disordermentioning

confidence: 99%

Current issues in child and adolescent psychopharmacology. Part 2: Anxiety and obsessive—compulsive disorders, autism, Tourette's and schizophrenia

Coghill¹

2003

Adv. psychiatr. treat

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This paper reviews the evidence base supporting the use of pharmacological treatments for child and adolescent psychiatric disorders. Recent advances in knowledge are highlighted, with some of the controversies. New evidence supports a role for selective serotonin reuptake inhibitors in the treatment of anxiety disorders and obsessive–compulsive disorder. Educational and behavioural approaches remain the mainstay of treatment for children and adolescents with autism, but there is evidence that adjunctive medication may be effective. Atypical antipsychotics have been investigated in the treatment of Tourette syndrome and early-onset schizophrenia. Many questions remain unanswered and further research is needed in all areas of paediatric psychopharmacology.

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Section: Obsessive-compulsive Disordermentioning

confidence: 99%

Current issues in child and adolescent psychopharmacology. Part 2: Anxiety and obsessive—compulsive disorders, autism, Tourette's and schizophrenia

Coghill¹

2003

Adv. psychiatr. treat

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“…Such levels could meet or exceed the MICs of sertraline against Cryptococcus isolates. In addition, abundant clinical data support the safety of long-term use of this antidepressant (6,28,29). Given its psychotropic nature and its potent fungicidal activity against Cryptococcus, we hypothesized that sertraline could be uniquely suitable in treating systemic cryptococcosis.…”

mentioning

confidence: 99%

The Antidepressant Sertraline Provides a Promising Therapeutic Option for Neurotropic Cryptococcal Infections

Zhai

Wang

et al. 2012

Antimicrob Agents Chemother

168

172

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Therapeutic treatment for systemic mycoses is severely hampered by the extremely limited number of antifungals. The difficulty of treatment of fungal infections in the central nervous system is further compounded by the poor central nervous system (CNS) penetration of most antifungals due to the blood-brain barrier. Only a few fungistatic azole drugs, such as fluconazole, show reasonable CNS penetration. Here we demonstrate that sertraline (Zoloft), the most frequently prescribed antidepressant, displays potent antifungal activity against Cryptococcus neoformans, the major causative agent of fungal meningitis. In in vitro assays, this neurotropic drug is fungicidal to all natural Cryptococcus isolates tested at clinically relevant concentrations. Furthermore, sertraline interacts synergistically or additively with fluconazole against Cryptococcus. Importantly, consistent with our in vitro observations, sertraline used alone reduces the brain fungal burden at an efficacy comparable to that of fluconazole in a murine model of systemic cryptococcosis. It works synergistically with fluconazole in reducing the fungal burden in brain, kidney, and spleen. In contrast to its potency against Cryptococcus, sertraline is less effective against strains of Candida species and its interactions with fluconazole against Candida strains are often antagonistic. Therefore, our data suggest the unique application of sertraline against cryptococcosis. To understand the antifungal mechanisms of sertraline, we screened a whole-genome deletion collection of Saccharomyces cerevisiae for altered sertraline susceptibility. Gene ontology analyses of selected mutations suggest that sertraline perturbs translation. In vitro translation assays using fungal cell extracts show that sertraline inhibits protein synthesis. Taken together, our findings indicate the potential of adopting this antidepressant in treating cryptococcal meningitis.

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“…SSRIs are considered to be tolerated well and with clear benefits over adverse events [39]. Long-term (up to 1 year) treatment seems to be necessary [25,40,41]. SSRI treatment can be accompanied by both common adverse events such as gastrointestinal distress and rarer symptoms such as an initial increase in suicidal thinking or behavior [1].…”

Section: Srismentioning

confidence: 99%

“…However, the SSRI group discontinued sertraline after 12 weeks [25]. Third, one would need to take into consideration that the recommended minimum duration of SRI treatment is 1 year [41]. By contrast, CBT is usually more timelimited and has a durable effect after treatment termination [25,45,46].…”

Section: Cbt or Ssris As The First Choicementioning

confidence: 99%

Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder

Skarphéðinsson

Ivarsson

2015

Curr Behav Neurosci Rep

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Pediatric obsessive-compulsive disorder (OCD) is a chronic, disabling, and common disorder. In this paper, we describe evidence-based treatments in treatment-naïve and treatment-refractory pediatric OCD patients. We conducted a PubMed search to identify randomized controlled trials, reviews, and expert guidelines. The evidence for cognitive behavior therapy (CBT) and specific serotonin reuptake inhibitors (SSRIs) among treatment-naïve patients is substantial and shows that both treatments are effective. Head-to-head trials in pediatric OCD only show that CBT is significantly more effective than SSRI. The evidence among CBT and SSRI non-responders is limited. One trial among CBT non-responders showed that both continued CBT and switching to an SSRI are effective strategies. Likewise, one trial among SSRI non-responders showed that augmenting with CBT is necessary. Evidence of treatments for treatment-refractory pediatric OCD is lacking. We describe the treatments available and evidence from studies of adult OCD. Evidence for emerging treatments such as modifying CBT and glutamatergic drugs is also described.

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Long-Term Sertraline Treatment of Children and Adolescents With Obsessive-Compulsive Disorder

Cited by 142 publications

References 17 publications

Current issues in child and adolescent psychopharmacology. Part 2: Anxiety and obsessive—compulsive disorders, autism, Tourette's and schizophrenia

Current issues in child and adolescent psychopharmacology. Part 2: Anxiety and obsessive—compulsive disorders, autism, Tourette's and schizophrenia

The Antidepressant Sertraline Provides a Promising Therapeutic Option for Neurotropic Cryptococcal Infections

Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder

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