Ali Mahmood Khan
Kings County Hospital Center, USA
Ali Mahmood Khan has completed his Medical School from Ziauddin University in Pakistan. After completing his degree, he came to USA and cleared all his USMLE exams, along with working as an extern at different prestigious hospitals in New York. In 2018, he matched for residency in Psychiatry at University of Texas (Rio Grande Valley). He has over 14 months of clinical experience in Psychiatry and has managed to publish 17 articles in this field. Currently, he continues to work as a Research Intern at Kings County Hospital Center.
Obsessive-compulsive disorder (OCD) is a common behavioral disorder among adolescents and children. The selective serotonin reuptake inhibitors (SSRI) are the first pharmacological choice for this condition due to mild adverse effect profile. This systematic review was performed to evaluate the efficacy of SSRI for OCD in adolescents and children. Search terms were entered into PubMed, PsycINFO, Scopus, CINAHL and Google Scholar. The included studies were randomized, placebo-controlled trials of SSRIs conducted in populations of children and adolescents younger than 18 years. Change from baseline CY-BOCS, end-treatment CY-BOCS with respective SD and response and remission rates were collected for continuous and dichotomous outcome assessment, respectively. Cochrane RevMan software was used for meta-analyses, providing Forest plots where applicable. SSRIs were superior to placebo with a small effect size. There was no additional benefit of combination treatment over CBT alone, but CBT added substantial benefit to SSRI monotherapy. Fluoxetine and Sertraline appear to be superior to Fluvoxamine. The results of current systematic review and meta-analysis support the existing NICE guidelines for choosing CBT as the first line of treatment and substituting it with SSRI depending on patient preference. Adding CBT to current SSRI treatment is effective for non-responders and partial responders, but adding SSRI to ongoing CBT does not prove beneficial. The SSRIs have different effectiveness and their relative efficacy remains to be investigated.