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Promoting OCD WEllness and resilience (POWER) study: Rationale, design, and methods.

Jessica D Leuchter1, Minjee Kook1, Daniel A Geller2

  • 1Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.

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This study investigates if children with obsessive-compulsive disorder (OCD) can stop serotonin reuptake inhibitors (SRIs) after cognitive behavioral therapy (CBT) and stay well. The POWER trial aims to provide data on SRI discontinuation in pediatric OCD.

Keywords:
ChildrenCognitive behavioral therapyObsessive-compulsive disorderPediatricRandomized controlled trialSerotonin reuptake inhibitorsYouth

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Area of Science:

  • Child and Adolescent Psychiatry
  • Clinical Psychology
  • Pharmacology

Background:

  • Obsessive-compulsive disorder (OCD) impacts 1-2% of children, causing significant functional impairment and reduced quality of life.
  • Effective treatments include cognitive behavioral therapy (CBT) with exposure and response prevention, and serotonin reuptake inhibitors (SRIs).
  • Current practice often uses SRIs as first-line treatment or in combination with psychotherapy, despite limited data on discontinuing them in pediatric OCD.

Purpose of the Study:

  • To address the gap in empirical data regarding the discontinuation of SRIs in youth with OCD.
  • To evaluate if children with OCD, after successful CBT augmentation, can discontinue SRI medication and maintain wellness.
  • To assess the efficacy of maintaining wellness for 24 weeks with maintenance CBT following SRI discontinuation.

Main Methods:

  • The study employs a two-phase, double-blinded, placebo-controlled, randomized controlled non-inferiority trial design.
  • Participants are youth diagnosed with OCD who are currently on SRI medication.
  • The trial will assess the ability to discontinue SRIs after successful CBT augmentation while receiving maintenance CBT.

Main Results:

  • This paper focuses on the rationale and methodological design of the POWER study.
  • Specific results regarding treatment efficacy and SRI discontinuation rates will be reported upon study completion.

Conclusions:

  • The POWER study is designed to provide crucial empirical data on SRI discontinuation in pediatric OCD.
  • Findings are expected to inform clinical practice and treatment guidelines for managing OCD in children and adolescents.
  • The study aims to support evidence-based decisions regarding medication management in conjunction with psychotherapy.