Treatment of OCD

Although there is no cure for obsessive-compulsive disorder, there are many effective OCD treatments, including certain medications and therapy. The type of treatment you select may vary based on severity of your OCD, the recommendation of your clinician, and what type of treatment makes you feel the most comfortable. Here we review the most common drug treatments and proven psycotherapeutic methods.

The main medicinal treatment for OCD is with selective serotonin reuptake inhibitors (SSRIs), which are antidepressants that block the absorption of the neurotransmitter serotonin in the brain. Although SSRIs are commonly given for depression, research has shown they can also be effective for the treatment of anxiety. Common side effects may include: headaches, nausea, sexual dysfunction, and diarrhea among others. The most commonly prescribed SSRIs for OCD are listed below.

Approved Medications

• Selective serotonin reuptake inhibitors (SSRIs):
• Paxil (paroxetine)
• Luvox (fluvoxamine)
• Prozac (fluoxetine)
• Zoloft (sertraline)
• Celexa (citralopram)
• Lexapro (escitalopram)
• Serotonin reuptake inhibitor (SRI):
• Anafranil (clomipramine)

There is some evidence that Anafranil may be slightly more effective in treating OCD, however it also tends to have more side effects, thus the trend toward prescribing newer generation SSRIs. Unfortunately, most people only find partial relief of their OCD symptoms from these medications, highlighting the importance of effective therapy strategies. In some cases, these medications may be augmented with additional medicines to make the more effective.

Cognitive-behavior therapy (CBT) is a type of psychotherapy that has been shown to be highly effective for OCD. The goal of CBT is two-fold: to change thoughts and behaviors. The cognitive portion involves the identification and analysis of unhelpful and unrealistic thoughts, which are then challenged. In the behavioral portion, the therapist and client work together to change the compulsive behaviors. This typically includes techniques such as Exposure and Response Prevention, also called Exposure and Ritual Prevention (EX/RP). In the exposure piece of the treatment, patients repeatedly expose themselves to their fears. By facing their obsessions in a systematic order, without performing compulsions, the person learns that there is nothing to fear and the obsessions begin to fade away. Learn more about CBT therapy...

The usefulness of other psychological treatments and alternative therapies is not known, as there is very little research. Psychodynamic therapy, also called or "talk" or "insight-oriented" therapy, is not effective but continues to be commonly used. There has been one published study on an alternative therapy, yogic meditation in the treatment of OCD, but no studies have been published on any other psychological treatment, such as hypnosis, virtual reality therapy, homeopathy, spiritual approaches, or an integrated psychological approach. People interested in alternative approaches should understand that there is not yet any evidence to support these practices. More study is needed before we will know if alternative treatments work for OCD.

OCD has been a specialty at the Center for the Treatment and Study of Anxiety since its founding in 1979. Many of the state-of-the-art treatments for this disorder have been developed at the Center. There are several treatment programs for adults with OCD.

Treatment of obsessive-compulsive disorder is typically completed in seventeen, 90-minute individual sessions with a therapist. This treatment emphasizes a behavioral approach to this disorder called Exposure and Ritual Prevention (EXRP). These sessions involve gradual exposure to one's feared thoughts and situations, while the patient learns to control compulsive behaviors such as washing and checking. Most patients complete treatment for their OCD over the course of 8.5 weeks. Medication treatments are also available for patients with OCD. These medications may be used in addition to, or instead of, cognitive-behavioral therapy.

Eligibility for the OCD programs is determined through an extensive interview with one of the center's clinicians. Patients receive a complete evaluation of OCD and related symptoms, and a thorough discussion of treatment options including free research studies and fee-for-service alternatives.