Alternative Pharmacological Treatments

Clonazepam upregulates 5-HT1 receptor binding sites may be used alone or augmentation of SSRIs less well tolerated than SSRIs or CMI

Change monotherapy to different SSRI or CMI

Augmentation Strategies: neuroleptics especially in those with comorbid tics risperidone 1 mg/day

Annotation: If SSRIs and CMI don’t work the psychopharmacologist must fall back on approaches for which there is no controlled data in in children.

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