Obsessive-compulsive disorder

:For other things named "OCD", see OCD (disambiguation). For other types of "obsession", see obsession (disambiguation). For other types of "compulsion", see compulsion (disambiguation).

Treatment

OCD can be treated with behavioral therapy (BT) or Cognitive therapy (CBT) and with a variety of medications. According to the Expert Consensus Guidelines for the Treatment of Obsessive-Compulsive Disorder (Journal of Clinical Psychiatry, 1995, Vol. 54, supplement 4), the treatment of choice for most OCD is behavior therapy or cognitive behavior therapy. Medications can help make the treatment go faster and easier, but most experts regard BT/CBT as clearly the best choice. Medications generally do not produce as much symptom control as BT/CBT, and symptoms invariably return if the medication is ever stopped.

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The specific technique used in BT/CBT is called Exposure and Ritual Prevention (also known as Exposure and Response Prevention) or ERP; this involves gradually learning to tolerate the anxiety associated with not performing the ritual behavior. At first, for example, someone might touch something only very mildly "contaminated" (such as a tissue that has been touched by another tissue that has been touched by the end of a toothpick that has touched a book that came from a "contaminated" location, such as a school). That is the "exposure." The "ritual prevention" is not washing. Another example might be leaving the house and checking the lock only once (exposure) without going back and checking again (ritual prevention). The person fairly quickly habituates to the (formerly) anxiety-producing situation and discovers that their anxiety level has dropped considerably; they can then progress to touching something more "contaminated" or not checking the lock at all — again, without performing the ritual behavior of washing or checking.

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Medication treatments include selective serotonin reuptake inhibitors such as paroxetine (Paxil, Aropax), sertraline (Zoloft), fluoxetine (Prozac), and fluvoxamine (Luvox) as well as the tricyclic antidepressants, and in particular clomipramine (Anafranil). Some medications like Gabapentin have also been found to be useful in the treatment of OCD. Symptoms tend to return, however, once the drugs are discontinued.

Related Topics:
Selective serotonin reuptake inhibitor - Paroxetine (Paxil, Aropax) - Sertraline (Zoloft) - Fluoxetine (Prozac) - Fluvoxamine (Luvox) - Tricyclic antidepressant - Clomipramine (Anafranil) - Gabapentin

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Recent research has found increasing evidence that opioids may significantly reduce OCD symptoms, though the addictive property of these drugs likely stands as an obstacle to their sanctioned approval for OCD treatment. Anecdotal reports suggest that some OCD sufferers have successfully self-medicated with opioids such as Ultram and Vicodin, though the off-label use of such painkillers is not encouraged, again because of their addictive qualities.

Related Topics:
Opioid - Ultram - Vicodin

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Hallucinogens, such as psilocybin (an active ingredient in "magic mushrooms") and LSD, have also shown promise — reducing symptoms for up to several months after ingestion in some people. The US FDA has approved a study to determine their effectiveness that is being conducted at the University of Arizona.

Related Topics:
Hallucinogens - Psilocybin - Magic mushrooms - LSD - FDA - University of Arizona

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