Paroxetine open-label treatment of pediatric outpatients with obsessive-compulsive disorder

Objective: Paroxetine is a selective serotonin reuptake inhibitor with demo nstrated efficacy in treating obsessive-compulsive disorder (OCD) in adults . This study evaluates the safety and effectiveness of paroxetine in pediat ric OCD patients. Method: In a 12-week, open-label trial of paroxetine, 20 OCD outpatients, aged 8 to 17 years, were treated for OCD with daily doses ranging from 10 to 60 mg. Target symptoms were rated at regular intervals w ith the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the Chi ldren's Global Assessment Scale, the Clinical Global Impression Scale, the Hamilton Anxiety Rating Scale, and the Yale Global Tic Severity Scale. Resu lts: Paroxetine proved relatively safe in this brief trial with a small sam ple and appeared to be effective in patients with OCD; mean CY-BOCS scores decreased significantly (z = 3.49, p = .0005) from 30.6 +/- 3.5 to 21.6 +/- 6.8 on medication. The most common side effects (n greater than or equal t o 2) were hyperactivity/behavioral activation, headache, insomnia, nausea, and anxiety. Paroxetine did not have to be discontinued in any of the patie nts because of side effects; the most serious side effects included hyperac tivity/behavioral activation in 3 younger patients (<10 years) necessitatin g dosage reduction but not discontinuation. Conclusions: Preliminary eviden ce suggests that short-term treatment of pediatric OCD outpatients with par oxetine may be relatively safe and effective.