Obsessive-compulsive disorder

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Overview

Symptoms

Treatment

Prevention

Obsessive-compulsive disorder

Alternative Names:

Obsessive-compulsive neurosis; OCD

Treatment:

OCD is treated using medications and psychotherapy.

The first medication considered is usually a type of antidepressant called a selective serotonin reuptake inhibitors (SSRI). These drugs include fluvoxamine (Luvox), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa).

If an SSRI does not work, an older antidepressant called clomipramine may be prescribed. Clomipramine is the oldest medication treatment for OCD. It works better than SSRI antidepressants in treating the condition, but it has unpleasant side effects, including sleepiness, difficulty starting urination, dry mouth, and a drop in blood pressure when rising from a seated position.

In some cases, an SSRI and clomipramine may be combined. Other medications such as benzodiazepines may offer some relief from anxiety, but they are generally used only with the more reliable treatments.

Psychotherapy is used to reduce anxiety, resolve inner conflicts, and provide effective ways of reducing stress.

Behavioral therapies may include:

Exposure/response prevention: The person is repeatedly exposed to a situation that triggers anxiety symptoms, and learns to resist the urge to perform the compulsion.
Thought-stopping: The person learns to stop unwanted thoughts and focus attention on relieving anxiety.

Expectations (prognosis):

OCD is a chronic (long-term) illness with periods of severe symptoms followed by times of improvement. However, a completely symptom-free period is generally unusual. With treatment, most patients have considerable improvement.

Complications:

The most likely long-term consequences of OCD are related to the nature of the obsessions or compulsions. For example, constant handwashing can cause skin breakdown. However, OCD does not ordinarily progress into another disease.

Calling your health care provider:

Call for an appointment with your health care provider if symptoms interfere with daily life, work, or relationships.

References:

Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. St. Louis, Mo: Mosby; 2004:167-170.

Rakel RE. Textbook of Family Practice. 6th ed. Philadelphia, Pa: WB Saunders; 2005:1348-1350.

Review Date: 5/8/2006
Reviewed By: Paul Ballas, D.O., Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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