Sertraline Combined With Fluvoxamine in the Treatment of Refractory Obsessive-compulsive Disorder

Inclusion Criteria:

• The Diagnostic criteria of OCD in the Diagnostic and Statistical Manual of MentalDisorders 5th edition (DSM-V), as well as the definition of refractory OCD, are asfollows: failure to respond to oral treatment with at least two effective doses ofantidepressants, including: Fluoxetine (≥20mg/ d), fluvoxamine (≥200mg/d), sertraline (≥150mg/d), and paroxetine (≥ 40mg/d) were all treated for at least 12 weeks. TheYale-Brown compulsive scale (Y-BOCS) score decreased by < 35%.
• The total score of Yale- Brown compulsion scale (Y-BOCS) ≥16 points. (3)age 12 ~ 45years.

Exclusion Criteria:

• Exclusion of severe organic brain disease;
• Severe physical illness;
• Other mental disorders such as tics, disruptive disorders, eating disorders and autismspectrum disorders;
• Pediatric streptococcal infection causedby autoimmune neuropsychiatric disease (PANDAS);
• Alcohol and drug dependence; Angle-closure glaucoma;
• Suicidal tendencies;
• Previous history of drug allergies related to research;
• Pregnant and lactating women.