Cognitive Behavior Therapy (CBT) has been shown to have many benefits over medication alone in treating OCD in children and adolescents. It tends to be faster-acting and more cost-effective over time, and it doesn’t involve the risk of side effects. Furthermore, studies have consistently shown that the positive gains associated with CBT are longer-lasting than those of medication; relapse rates are lower when CBT is discontinued than when medication is stopped.
In some cases, however, medication is prescribed in conjunction with CBT. It may be helpful, for example, when OCD is moderate to severe or if there are coexisting disorders, such as depression, that impede a person’s ability to do CBT. Medication is often prescribed on a temporary basis; once the child is able to better manage the anxiety and stress during CBT, the medication may be tapered off and then eliminated.
It’s important to work with a physician (for example, a psychiatrist) who is experienced in prescribing and monitoring different medications for OCD in children and adolescents. The physician should advise you about the possible side effects of medications, assess their effectiveness, and, if appropriate, provide instructions for tapering off the dosage. Medications should never be discontinued abruptly.
Antidepressants classified as serotonin reuptake inhibitors, which include serotonin-specific reuptake inhibitors (SSRIs), have been shown to be the most effective medications for children and adolescents with OCD. Because body chemistry differs so much across individuals, the type and dosage of medication prescribed will vary. Some children with OCD respond well to the first drug prescribed; others must try more than one (under close medical supervision), to find the medication that produces the best results.
Most of these medications do not produce immediate relief from OCD symptoms. Some may begin to work after a few weeks, but it may take 10 to 12 weeks at therapeutic doses to be effective. In fact, many individuals experience only side effects during the first few weeks of treatment. But after a period of time, they may see a big improvement in their symptoms. CBT may begin at any time after medication is prescribed, depending on the person’s reaction to the drugs.
The best way to enhance the effectiveness of medication is to add behavior therapy to ongoing drug treatment. But when OCD isn’t responsive to CBT and trials with a number of different SSRIs, physicians sometimes add another drug to boost a particular medication’s effectiveness, overall. This is known as augmentation therapy.
As difficult as it can be, parents must try to be as patient as possible throughout the process of trying to find the best medication for your child. It’s natural to want immediate relief for your son or daughter, but the prescribing physician (e.g., psychiatrist) will most likely start with a low dose of medication and increase it, as appropriate. You will play an extremely important role in terms of monitoring your child’s behavior and reaction to the medication, including side effects.
Questions to Ask the Doctor about Medication for Your Child
Your child’s doctor may recommend medication, and, as a parent, it’s natural to have concerns about medicating your child. If this is the case, you’ll want to become knowledgeable about drugs used to treat OCD, how they work, and any possible side effects. Be sure to talk with the doctor and ask questions to help you get the best information possible.