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A Double-blind Desipramine Substitution During Long-term Clomipramine Treatment in Children and Adolescents With Obsessive-Compulsive Disorder

Henrietta L. Leonard, MD; Susan E. Swedo, MD; Marge C. Lenane, MSW; David C. Rettew; Deborah L. Cheslow, MA; Susan D. Hamburger, MS; Judith L. Rapoport, MD
Arch Gen Psychiatry. 1991;48(10):922-927. doi:10.1001/archpsyc.1991.01810340054007.
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• Twenty-six chilndren and adolescents with severe primary obsessive-compulsive disorder receiving long-term clomipramine hydrochloride maintenance treatment (mean±SD, 17.1±8.3 months; range, 4 to 32 months) entered an 8-month double-blind desipramine hydrochloride substitution study to assess the necessity of continued drug treatment. All patients received clomipramine for the first 3 months, then half continued with clomipramine therapy (nonsubstituted group) and half had desipramine blindly substituted for the next 2 months; all subjects again received clomipramine for the last 3 study months. Eight (89%) of nine of the substituted and only two (18%) of 11 of the nonsubstituted group subjects relapsed during the 2-month comparison period. Long-term clomipramine treatment seems necessary for this population of children and adolescents with obsessive-compulsive disorder. However, even patients receiving maintenance clomipramine treatment throughout the entire study had continued obsessivecompulsive symptoms, which varied in severity over time.

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