A 12-year-old boy with OCD has a comorbid tic disorder. Compared to OCD without tics, which treatment modification is most supported by evidence?

• A Higher doses of SSRIs are always required
• B Addition of an antipsychotic to SSRI may provide greater benefit ✓
• C CBT is contraindicated
• D Clomipramine is the preferred first-line agent

Explanation

OCD with comorbid tics shows a poorer response to SSRIs alone, and evidence supports antipsychotic augmentation in this subgroup. Higher SSRI doses are not universally required. CBT remains effective and is not contraindicated. Clomipramine is not preferred over SSRIs as first-line due to its side effect profile.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

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