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Neuere kognitive und metakognitive Techniken fokussieren auf die Modifikation von Erwartungen und haben vielleicht das Potential, die Wirksamkeit der Behandlung zu verbessern. Selektive Serotonin-Wiederaufnahme-Hemmer (selective serotonin reuptake inhibitors, SSRIs) stellen die Medikamente der ersten Wahl zur Behandlung der kindlichen Zwangsst\u00f6rung dar. Wenn die Patienten bei ausreichend langer Gabe nicht auf die Medikation ansprechen, sollte ein Therapieversuch mit einem alternativen SSRI oder mit Clomipramin durchgef\u00fchrt werden. Bei einem erneuten Scheitern der Behandlung kann eine Augmentation mit einer Kombination zweier SSRIs bzw. einem SSRI und Clomipramin oder einem SSRI und einem (atypischen) Neuroleptikum erfolgen. Nach einer erfolgreichen Behandlung sollte das Ausschleichen der Medikation sehr langsam erfolgen. 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