Three case studies of children aged 11-12 years are reported in which very low doses (12.5 mg) of sertraline are compared with inactive placebo in a cross-over study, to see if low doses are effective in improving symptoms of obsessive-compulsive disorder (OCD). In these cases low doses of sertraline had a significant beneficial effect. To our knowledge, this is the first report of the use of very low doses in the treatment of children with OCD. Previous studies have used adult doses. These case reports should be viewed as offering initial encouragement to the use of low-dose sertraline in the treatment of children with pure OCD or co- morbid OCD, and encourage further studies with larger numbers of children. Although sertraline is not yet licensed for the treatment of OCD in this age group, it is a useful drug to consider. Given that adverse side-effects are dose related, and often result in premature discontinuation of medication, starting at a low dose, i.e. 12.5 mg may prove clinically effective in some children, avoid unnecessary side- effects and assist with treatment adherence and improved outcome.
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