scholarly journals Psychopharmacological Treatment of Obsessive-Compulsive Disorder (OCD)

2019 ◽  
Vol 17 (8) ◽  
pp. 710-736 ◽  
Author(s):  
Antonio Del Casale ◽  
Serena Sorice ◽  
Alessio Padovano ◽  
Maurizio Simmaco ◽  
Stefano Ferracuti ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Clinical Guidelines ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Mood Stabilizers ◽  
Obsessive Compulsive ◽  
Global Functioning ◽  
Comprehensive Overview ◽  
Compulsive Disorder ◽  
Pubmed Database

Background:Obsessive-compulsive disorder (OCD) is associated with affective and cognitive symptoms causing personal distress and reduced global functioning. These have considerable societal costs due to healthcare service utilization.Objective:Our aim was to assess the efficacy of pharmacological interventions in OCD and clinical guidelines, providing a comprehensive overview of this field.Methods:We searched the PubMed database for papers dealing with drug treatment of OCD, with a specific focus on clinical guidelines, treatments with antidepressants, antipsychotics, mood stabilizers, off-label medications, and pharmacogenomics.Results:Prolonged administration of selective serotonin reuptake inhibitors (SSRIs) is most effective. Better results can be obtained with a SSRI combined with cognitive behavioral therapy (CBT) or the similarly oriented exposure and response prevention (ERP). Refractory OCD could be treated with different strategies, including a switch to another SSRI or clomipramine, or augmentation with an atypical antipsychotic. The addition of medications other than antipsychotics or intravenous antidepressant administration needs further investigation, as the evidence is inconsistent. Pharmacogenomics and personalization of therapy could reduce treatment resistance.Conclusion:SSRI/clomipramine in combination with CBT/ERP is associated with the optimal response compared to each treatment alone or to other treatments. New strategies for refractory OCD are needed. The role of pharmacogenomics could become preponderant in the coming years.

Cognitive-Behavioral Therapy and Integrated Approaches in the Treatment of Obsessive-Compulsive Disorder

CNS Spectrums ◽  
1999 ◽  
Vol 4 (S3) ◽  
pp. 35-40 ◽  
Author(s):  
Fritz Hohagen
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Mental Condition ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

AbstractObsessive-compulsive disorder (OCD) has long been considered a treatment-refractory mental condition. Neither pharmacologic nor psychodynamic therapy has been proven to treat OCD effectively. Yet the prognosis for OCD has changed dramatically in recent years with the introduction of behavior therapy and the use of selective serotonin reuptake inhibitors (SSRIs). Many studies have shown that behavior therapy, especially exposure with response prevention, and SSRIs reduce obsessive-compulsive symptoms significantly. Still, many unanswered questions—including the role of cognitive therapy in the treatment of OCD, exposure therapy vs multimodal behavioral therapy, individual versus group therapy, outcome predictors in adults, adolescents, and children, and the role of combination treatment using an SSRI and cognitive-behavioral therapy—remain. This article will explore these issues as well as suggest directions for further research into OCD.

Objective and subjective improvement after a new form of cognitive and behavioral therapy for obsessive compulsive disorder patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 975-975
Author(s):  
M. Morgieve ◽  
A.-H. Clair ◽  
A. Saulton ◽  
K. N’Diaye ◽  
A. Pelissolo ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Symptom Severity ◽  
Behavioral Therapy ◽  
Matching Task ◽  
Subjective Improvement ◽  
Obsessive Compulsive ◽  
Global Functioning ◽  
Compulsive Disorder ◽  
Pedagogic Tool ◽  
Cognitive And Behavioral Therapy

IntroductionCognitive and Behavioral Therapy (CBT) is one of the two treatments recognized as most efficient to improve Obsessive Compulsive Disorder (OCD) symptoms.ObjectivesThe major aim of this study is to facilitate CBT for OCD checkers. To this purpose, we developed a new psycho-pedagogic tool to be used during CBT sessions and assessed its objective efficacy and the patients’ perception of their therapy.MethodologyExperimental CBT sessions included a “checking task”, composed of a “matching task” followed by a “checking phase” during which subjects were given the opportunity to check or to confirm their prior answer. This tool was appended to a classical CBT (as described in the literature).30 OCD patients with checking compulsions each followed 15 individual CBT sessions with a psychologist. They were randomized in two groups: a “reference CBT” (CBT classically described in literature) and an “experimental CBT” (reference CBT + checking task) group. Symptom severity was assessed by the Y-BOCS and CGI at three main stages of the therapies: before, at half-therapy, at the end of therapy and 6 months later. Assessment was performed blindly by an expert psychologist to avoid any bias, and the patients’ impressions were collected at the same time.ResultsAt the end of therapies, symptom severity decreased significantly (24.08 to 12.5) and participants had a better global functioning, especially in their social and familial lives.ConclusionsBoth CBT offer an important clinical improvement of OCD symptoms. Patients and psychologists expressed their satisfaction at having participated to the study.

Couple-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder

2021 ◽  
pp. 370-383
Author(s):  
Jennifer L. Buchholz ◽  
Jonathan S. Abramowitz ◽  
Samantha N. Hellberg ◽  
Heidi J. Ojalehto
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Symptom Severity ◽  
Behavioral Therapy ◽  
Response Prevention ◽  
Obsessive Compulsive ◽  
Global Functioning ◽  
Interpersonal Dynamics ◽  
Case Examples ◽  
Compulsive Disorder

For a number of reasons, it may be critical to involve a romantic partner or spouse in exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD). Indeed, relationship stress focal to OCD is associated with greater symptom severity, a more severe course, and poor global functioning. Research also indicates that involving partners or spouses to serve as coaches for their OCD-affected partners during ERP improves the efficacy of this treatment. This chapter describes the nature and treatment of OCD, focusing on interpersonal dynamics, and outlines a couple-based ERP program for individuals with OCD who are in long-term relationships. Case examples are included to illustrate the techniques used in this program.

New Pharmacotherapeutic Approaches to Obsessive-Compulsive Disorder

CNS Spectrums ◽  
2009 ◽  
Vol 14 (S3) ◽  
pp. 13-23 ◽  
Author(s):  
Martijn Figee ◽  
Damiaan Denys
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Response To Treatment ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Recent Developments ◽  
Patients At Risk ◽  
Treatment Refractory ◽  
Norepinephrine Reuptake

AbstractThis article summarizes results of all pharmacotherapy trials for obsessive-compulsive disorder (OCD) published from 2006 to 2008 as well as studies on markers for predicting response to treatment and neurobiological changes induced by pharmacotherapy. Results show that recent developments in the treatment of OCD have been modest and primarily involve evidence for the efficacy of escitalopram and other selective serotonin reuptake inhibitors (SSRIs); augmentation with antipsychotics in treatment-refractory patients and combination treatment with D-cycloserine and cognitive-behavioral therapy has also been effective. The efficacy of serotonin-norepinephrine reuptake inhibitors remains inconclusive. Studies on markers of clinical response have shown inconsistent results, however, duration and severity of OCD and the presence of comorbidities can often identify patients at risk for nonresponse. Lastly, successful treatment with an SSRI results in both serotonergic and dopaminergic changes, but more research is necessary in order to define the biological characteristics of responders and nonresponders.

scholarly journals Thermocoagulation as a Surgical Approach for the Treatment of Obsessive-Compulsive Disorder in Refractory Patients: Systematic Review

2021 ◽  
Author(s):  
Lucas Praxedes Chaves ◽  
Álef Ribeiro Souza ◽  
Ledismar José da Silva ◽  
Laura de Lima Crivellaro ◽  
Marina Ferreira da Silva
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Therapeutic Option ◽  
High Morbidity ◽  
Obsessive Compulsive ◽  
Noninvasive Treatment ◽  
Compulsive Disorder

AbstractObsessive-compulsive disorder (OCD), a disabling chronic neuropsychiatric disease, entails high economic costs to society and has high morbidity and mortality rates. The first-line treatments for OCD are selective serotonin reuptake inhibitors and cognitive-behavioral therapy. However, this disorder has the highest refractory index to noninvasive treatment. Alternatively, ablative thermocoagulation neurosurgical techniques have shown efficacy and few adverse effects. The present systematic review aimed to identify validated protocols to observe the effectiveness of ablative procedures in the treatment of severe and refractory OCD, as well as their possible adverse effects and benefits. This review supports the effectiveness of ablative methods by presenting them as a safe non-experimental therapeutic option for cases of highly-refractory OCD. Additional relevant findings were the improvement in cognitive function, functional capacity, affective orientation, and quality of life, which contribute to the destigmatization of this surgical technique. Further controlled studies may lead to the individualization of recommendations of targets for ablative thermocoagulation.

Anxiety, Obsessive-Compulsive, and Stress Disorders

2014 ◽  
Author(s):  
Franklin R. Schneier ◽  
Hilary B. Vidair ◽  
Leslie R. Vogel ◽  
Philip R. Muskin
Keyword(s):  
Anxiety Disorder ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Stress Disorders ◽  
Panic Attacks ◽  
Social Situations ◽  
First Line ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Patients with generalized anxiety disorder experience anxiety related to multiple areas, such as work, finances, and illness. Discrete, unexpected panic attacks and anticipatory anxiety characterize patients with panic disorder. Patients with social anxiety disorder have fear of embarrassment in social situations. Patients with obsessive-compulsive disorder are preoccupied with and distressed by inappropriate thoughts, urges, and images. The four cardinal features of posttraumatic stress disorder are intrusive reexperiencing of the initial trauma, avoidance, persistent negative alterations in cognitions and mood, and alterations in arousal and activity. One element common to patients suffering from most of the anxiety disorders is an elevated sensitivity to threat, which appears to involve brain systems identified to mediate “fear” responses, including the amygdala. The selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are the first-line pharmacotherapy treatment for obsessive-compulsive disorder and most of the anxiety and stress disorders. Cognitive-behavioral therapy for anxiety, obsessive-compulsive, and stress disorders is an empirically validated time-limited treatment.

The Medical Treatment of Obsessive-Compulsive Disorder and Anxiety

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S14) ◽  
pp. 37-46 ◽  
Author(s):  
Borwin Bandelow
Keyword(s):  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Behavioral Therapy ◽  
Treatment Options ◽  
First Line ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
History Of ◽  
Higher Doses

AbstractSelective serotonin reuptake inhibitors (SSRIs) are first-line pharmacotherapy treatments for obsessive-compulsive disorder (OCD). Clomipramine is effective in OCD but associated with more adverse events. Typically, higher doses of antidepressants are required for OCD. Up to 50% of patients do not respond to initial treatment of OCD. Treatment options for nonresponders include augmentation of antidepressants with atypical antipsychotics, among other strategies. First-line treatments for anxiety disorders include SSRIs, serotonin norepinephrine reuptake inhibitors, and pregabalin. Tricyclic antidepressants are equally effective as SSRIs, but are less well tolerated. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of dependency and tolerance. Other treatment options include irreversible and reversible monoamine oxidase inhibitors, the atypical antipsychotic quetiapine, and other medications. Cognitive-behavioral therapy has been sufficiently investigated in controlled studies of OCD and anxiety disorders and is recommended alone or in combination with the above medications.

scholarly journals Effectiveness, Timing and Procedural Aspects of Cognitive Behavioral Therapy after Deep Brain Stimulation for Therapy-Resistant Obsessive Compulsive Disorder: A Systematic Review

2020 ◽  
Vol 9 (8) ◽  
pp. 2383 ◽  
Author(s):  
Meltem Görmezoğlu ◽  
Tim Bouwens van der Vlis ◽  
Koen Schruers ◽  
Linda Ackermans ◽  
Mircea Polosan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Brain Stimulation ◽  
Cognitive Behavioral Therapy ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Clinical Guidelines ◽  
Behavioral Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

Background and aim: Deep brain stimulation (DBS) is an effective treatment for patients with severe therapy-resistant obsessive-compulsive disorder (OCD). After initiating DBS many patients still require medication and/or behavioral therapy to deal with persisting symptoms and habitual behaviors. The clinical practice of administering postoperative cognitive behavioral therapy (CBT) varies widely, and there are no clinical guidelines for this add-on therapy. The aim of this review is to assess the efficacy, timing and procedural aspects of postoperative CBT in OCD patients treated with DBS. Method: Systematic review of literature. Results: The search yielded 5 original studies, one case series and three reviews. Only two clinical trials have explicitly focused on the effectiveness of CBT added to DBS in patients with therapy-resistant OCD. These two studies both showed effectiveness of CBT. However, they had a distinctly different design, very small sample sizes and different ways of administering the therapy. Therefore, no firm conclusions can be drawn or recommendations made for administering CBT after DBS for therapy-resistant OCD. Conclusion: The effectiveness, timing and procedural aspects of CBT added to DBS in therapy-resistant OCD have hardly been studied. Preliminary evidence indicates that CBT has an added effect in OCD patients being treated with DBS. Since the overall treatment effect is the combined result of DBS, medication and CBT, future trials should be designed in such a way that they allow quantification of the effects of these add-on therapies in OCD patients treated with DBS. Only in this way information can be gathered that contributes to the development of an algorithm and clinical guidelines for concomittant therapies to optimize treatment effects in OCD patients being treated with DBS.

Sign in / Sign up

Export Citation Format

Share Document