Obsessive Compulsive Disorder Treament
Family and genetic studies have shown significant associations between obsessive-compulsive disorder (OCD) and other psychiatric disorders such as generalized anxiety disorder, panic disorder, depression, hypochondriasis, body dysmorphic disorder, trichotillomania, obsessive-compulsive personality disorder, and avoidant personality disorder. Therefore if you are seeking treatment for OCD it is important for your psychiatrist to screen for these other disorders as they may affect the treatment efficacy. This is even more true since OCD per se can be challenging to treat and remission rates are low despite the introduction of several new evidenced-based treatments over the past two decades.
The current state of art for OCD treatment includes one or more of the following: psychotherapy, behavioral therapy, medications, and neurosurgery. In this section I will focus on the pharmacotherapy of OCD. First-line treatments are serotonin reuptake inhibitors such as clomipramine (Anafranil), venlafaxine (Effexor), duloxetine (Cymbalta), escitalopram (Lexapro), and others in the same class. Several medications from other classes have also shown some efficacy as stand-alone or add-on treatments: Monoamine oxidase inhibitors (MAOI) such as phenelzine (Nardil) seem particularly helpful for OCD patients who also have panic attacks. Newer antipsychotic agents may be of help when combined with SRIs, including Risperdal, Seroquel, Geodon, Abilify – especially for OCD patients who also suffer from tic disorder. Finally, more recent research has provided evidence of excess glutamate in certain regions of the OCD brain. This had led to some promising trials with medications such as memantine (Namenda), riluzole (Rilutek), and N-acetyl cysteine (NAC). In summary, understanding the etiology, pathophysiology, and treatment of OCD and related disorders is an area of intense research, and we are fortunate that several treatment modalities have shown good results. If you are seeking help with OCD discuss these evolving treatments with your psychiatrist.
For more information about OCD and its treatment visit The OCD Foundation: www.ocfoundation.org