Therapy

Cognitive-Behavioral Therapy-
One effective treatment is a type of cognitive-behavioral therapy known as exposure and response prevention. During treatment sessions, patients are exposed to the situations that create anxiety and provoke compulsive behavior or mental rituals. Through exposure, patients learn to decrease and then stop the rituals that plague their lives. They find that the anxiety arising from their obsessions lessens without engaging in ritualistic behavior. This technique works well for patients whose compulsions focus on situations that can be re-created easily. For patients who engage in compulsive rituals because they fear catastrophic events that can’t be re-created, therapy relies on imagining exposure to the anxiety-producing situations. Throughout therapy the patient follows exposure and response prevention guidelines on which the therapist and patient agree. Cognitive-behavior therapy can help many OCD patients substantially reduce their OCD symptoms. However, treatment only works if patients adhere to the procedures. Some patients will not agree to participate in cognitive-behavioral therapy because of the anxiety it involves, and others have depression that must be treated simultaneously.


Medication-
A class of medications known as serotonin reuptake inhibitors (SRIs) is effective in the treatment of OCD. Each SRI can be expected to help about half of those who try it, and patients who do not respond to one sometimes respond to another. Marked benefit usually takes six to twelve weeks to occur. SRIs that are proven effective in OCD include clomipramine, fluoxetine, fluvoxamine, paroxetine, and sertraline. Other psychotropic medications that may be effective are citalopram, escitalopram, and venlafaxine. These medications, though very helpful, often leave residual symptoms and these residual symptoms are treated by augmenting SRIs with other medications or with cognitive-behavioral therapy.