Treatment of Obsessive compulsive disorder

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There are two methods of treatment for OCD, drug therapy and cognitive behavioural therapy. A combination of the two therapies is often an effective method of treatment for most people.

Drug therapy

Antidepressant medication is commonly prescribed (whether depression is present or not present). Clomipramine, a tricyclic antidepressant (TCA) used to be the usual treatment, this worked well. However TCAs have more side effects than the newer Selective Serotonin reuptake inhibitors (SSRI's). Therefore initially in most cases now, SSRIâ€™s are prescribed because of the improved safety, tolerability, and equivalent effectiveness. However, no SSRIs except fluoxetine (Prozac) should be prescribed to children and adolescents under the age of 18, due to increased risks. Medications will usually relieve the symptoms of OCD, but often, if the medication is discontinued, relapse will follow.

Medication usually works within 4 weeks but may take up to 10 weeks to work fully. If successful, it is usual to take medication for at least a year. The doses needed to treat OCD are sometimes higher than those needed to treat depression. Symptoms can improve by up to 60% with medication.

Cognitive Behavioural Therapy (CBT)

CBT involves exploring the nature of anxiety and stress responses. The therapist will then gradually expose the individual to the feared object or idea, either directly or by imagination, and then discourages or prevents them from carrying out the usual compulsive response. The aim is for the individual to gradually experience less anxiety from the obsessive thoughts and become able to forgo the compulsive actions for extended periods of time.

Some people with OCD find CBT too stressful. CBT is not available in all areas of the UK. However, some people successfully manage their own therapy with the help and advice of support groups.