Clomipramine-fluoxetine association in obsessive adolescents showing no response to monotherapy: plasma levels and clinical effects

Abstract

Serotoninergic antidepressants (IRS) have proved ef/ective in obsessive-compulsive disorder (OCD), nevertheless about 26-40% of children and adolescents with OCD show not response to IRS in monotherapy. Two adolescents (17 and 18 year old) with OCD have been treated with a number of serotoninergic antidepressants on monotherapy improving partially specially with Clomipramine (CIM) with doses of up to 225 mglday. Dueto persistence of obssesive symptoms, in one case, and intense and recurrent dysthimias, in the other, therapy combining both CIM, with adjusted doses of 3 7.5 mglday, and Fluoxetine (FXTJ, with doses of 20 mglday, was started. There were no changes in symptoms during the first three weeks. Adverse e.ffects related to CLM bigb plasma levels were absent. On the Jourth week a progresive good response was seen in botb patients with remission of obsessive-compulsive symptoms and euthymic state. No adverse e.ffects were obserued. After a month CLM (63 and 74 mmol/L) and Demethylclomipramine (132 and 153 mmol/L) plasma levels stayed on therapeutic levels.