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Achieving Wellness from Obsessive Compulsive Disorder is a treatment study sponsored by NIMH.

Treatment of OCD

There are many effective treatments for obsessive-compulsive disorder, including medication and therapy. The type of treatment you select may vary based on severity of your OCD, the recommendation of your clinician, and what type of treatment makes you feel the most comfortable.

Antidepressant Medications: SRIs

The main pharmaceutical treatment for OCD is with serotonin reuptake inhibitors (SRIs), which are antidepressants that block the re-absorption of serotonin in the brain. Although SRIs are commonly prescribed for depression, research has shown they can also be effective for the treatment of anxiety. Dosages for the anti-obsessional qualities are often higher than typically needed for anti-depressant effects. The table below lists the SRIs most often prescribed for OCD, and what is generally considered an adequate dose for OCD based on the current literature. However, some individuals respond with lower doses and others require even higher doses. Common side effects of these medications include: headaches, nausea, sexual dysfunction, and diarrhea among others.

Medication

Usual Target Dose (mg/day)

Celexa (Citalopram)

40–60

Anafranil (Clomipramine)

100–250

Lexapro (Escitalopram)

20

Prozac (Fluoxetine)

40–60

Luvox (Fluvoxamine)

200

Paxil (Paroxetine)

40–60

Zoloft (Sertraline)

200

Note: If your dose is different than the above, you may still qualify for our study.

OCD Treatment by Therapy

Cognitive-behavior therapy (CBT) is a type of psychotherapy that has been shown to be highly effective for OCD. The goal of CBT is three-fold: to change thoughts, emotions, and behaviors. The cognitive and emotional parts involve helping patients change unhelpful and unrealistic thoughts and unwarranted negative emotions. In the behavioral part, the therapist helps the patients overcome the compulsive behaviors. For OCD, this typically involves a therapy called Exposure and Ritual Prevention (EX/RP, or sometimes abbreviated as ERP). In the exposure piece of the treatment, patients repeatedly approach situations that cause them OCD-related distress. By facing their obsessions in a systematic way, without performing compulsions (the ritual prevention piece), the patient learns that their expected bad consequences as a result of exposure will not happen.

Treatment of OCD at Our Centers

OCD has been a specialty at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania since its founding in 1979. Many of the state-of-the-art treatments for this disorder have been developed at the Center through its research studies. The Center also hosts an open clinic, with numerous therapists on staff who are experts in the treatment of OCD.

The New York State Psychiatry Institute at Columbia University runs a Research Program for OCD and Related Disorders in their Anxiety Disorders Clinic. The Program conducts cutting-edge research to advance the understanding of OCD in order to develop new and better treatments. Since 1982 it has been a driving force behind the recent advances in the recognition, understanding, and/or treatment of OCD and related disorders.

Treatment of obsessive-compulsive disorder at both centers is typically completed in 17 to 25 ninety-minute individual sessions with a therapist. This treatment emphasizes the approach to this disorder called Exposure and Response Prevention (EXRP). These sessions involve gradual exposure to one's feared thoughts and situations, while the patient learns to control compulsive behaviors such as washing and checking. Most patients complete treatment for their OCD over the course of 8.5 to 12 weeks.