ArticleJournal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent2021
Clomipramine in Combination with Fluvoxamine: A Potent Medication Combination for Severe or Refractory Pediatric OCD.
Article in Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.
- Dutch Pharmacogenetics Working Group (DPWG) guideline for the gene-drug interaction between CYP2D6 and CYP2C19 and tricyclic antidepressants.European journal of human genetics : EJHG · 2026Guideline
- Inpatient Child Psychiatry Research: Time to be more Experimental.Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2021Article
- Response to "Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2021Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clomipramine (CMI) and fluvoxamine (FLV) combination therapy has been shown in adults to be a potent medication strategy for obsessive compulsive disorder (OCD). Fung et al. (2021) is the first to show similar benefit in pediatric OCD. The addition of FLV to CMI inhibits the metabolism of clomipramine to desmethylclomipramine (DCMI) and enhances the serotonergic potency of CMI by shifting the routine ratio of CMI<DCMI to CMI>DCMI via inhibition of the CYP450 system. The approach to CMI+FLV combination therapy outlined by Fung et al. requires close monitoring. This commentary reviews the benefits and challenges of the approach of Fung et al. (2021) and provides other strategies to take advantage of this combination. Clinicians may consider starting with CMI and adding FLV for patients with refractory OCD to offer a faster pathway to potentially more effective treatment. If a clinician prefers starting with SSRI monotherapy, choosing FLV initially allows for a simpler transition to CMI+FLV in the event that SSRI monotherapy fails.
Indexed as
Identifiers
34777510PMC8561855W3214402662What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.