Using the Cochrane methodology , and as measures of effect size mean difference and Hedge 's g , SRIs proved to be superior to drug placebo , with a modest effect size .
From direct comparisons of CBT and SRI treatments , we conclude that CBT has the superior efficacy .
COMBO versus CBT shows that SRI treatment adds little to concomitant CBT , while COMBO shows favourable outcome versus SRI alone .
In pre-trial partial treatment responders , those who failed a SRI had better outcome from adding CBT as compared to continuing a SRI .
Those who failed CBT treatment did as well with continued CBT as with switching to a SRI .
Serotonin reuptake inhibiting drugs ( SRI ) have been used in the treatment of paediatric obsessive-compulsive disorder over the past 30 years .
Paroxetine treatment in children and adolescents with obsessive-compulsive disorder: a randomized, multicenter, double-blind, placebo-controlled trial.
OBJECTIVE To assess the efficacy and safety of paroxetine for the treatment of pediatric obsessive-compulsive disorder . METHOD Children ( 7 - 11 years of age ) and adolescents ( 12 - 17 years of age ) meeting DSM-IV criteria for obsessive-compulsive disorder were r and omized to  paroxetine  ( 10 - 50 mg/day ) or placebo for 10 weeks . The primary efficacy measure was change from baseline in the Children 's Yale-Brown Obsessive-Compulsive Scale ( CY-BOCS ) total score at week 10 last observation carried forward end point . Safety was assessed primarily through adverse event monitoring . RESULTS A total of 207 patients were r and omized to treatment . Of these , 203 were included in the intention-to-treat population . Adjusted mean changes from baseline at week 10 observation carried forward end point in CY-BOCS total score for patients receiving paroxetine and placebo were -8.78 ( SE=0.82 ) and -5.34 points ( SE=0.77 ) , respectively . The adjusted mean difference , -3.45 in favor of paroxetine , was statistically significant ( 95 % confidence interval=-5.60 to -1.29 , p=.002 ) . Adverse events were generally mild to moderate in intensity . A total of 10.2 % ( 10/98 ) of patients in the paroxetine group and 2.9 % ( 3 of 105 ) in the placebo group discontinued treatment because of adverse events . CONCLUSIONS Paroxetine is an effective and generally well-tolerated treatment for obsessive-compulsive disorder in children and adolescents
Using the Cochrane methodology , and as measures of effect size mean difference and Hedge 's g , SRIs proved to be superior to drug placebo , with a modest effect size .
From direct comparisons of CBT and SRI treatments , we conclude that CBT has the superior efficacy .
COMBO versus CBT shows that SRI treatment adds little to concomitant CBT , while COMBO shows favourable outcome versus SRI alone .
In pre-trial partial treatment responders , those who failed a SRI had better outcome from adding CBT as compared to continuing a SRI .
Those who failed CBT treatment did as well with continued CBT as with switching to a SRI .
Serotonin reuptake inhibiting drugs ( SRI ) have been used in the treatment of paediatric obsessive-compulsive disorder over the past 30 years .