Medication management with SRIs presents another empirically-supported treatment option for youth with OCD. The SRIs that have been evaluated in RCTs for youth with OCD include clomipramine (CMI),[26–28] sertraline (SERT),[19; 29] fluoxetine (FLUX),[30–32] paroxetine (PAX),[33] and fluvoxamine (FLUV).[34] These medications significantly reduce obsessive-compulsive symptom severity relative to placebo and waitlist control conditions, with some evidence suggesting that CMI is superior to selective SRIs (SERT, FLUX, PAX, FLUV).[35] Long-term benefit from acute SRI treatment has been observed for up to 12 months with maintenance medication,[36] however symptom reemergence can occur with discontinued use.[37; 38] While appropriate safety and tolerability monitoring are needed due to side-effect concerns,[39; 40] SRI medications are recommended as first-line interventions for youth with moderately severe OCD.[11]
