Treatment Options for Obsessive-Compulsive Disorder

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People who have obsessive-compulsive disorder (OCD) experience disturbing intrusive thoughts; many also engage in repetitive compulsive behavior that is intended to address the disturbing thoughts. These thoughts and behaviors interfere with everyday life and make it difficult for people with OCD to maintain relationships and professional responsibilities.

Obsessive-compulsive disorder is a chronic condition. With treatment, most people will experience symptom relief. According to the International OCD Foundation, 70% of people with OCD will improve with therapy and/or medication. Additional treatments are available for those who continue to suffer despite therapy and medication.

Treatments for obsessive-compulsive disorder include:

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy helps individuals reframe their thoughts and choose other behaviors. In simplest terms, OCD is experienced as a repetitive loop: The affected individual experiences an intrusive thought, which creates feelings of unease and distress. The individual engages in a specific behavior to ease that stress. When the intrusive thought occurs again, so does the behavior.

CBT teaches individuals to interrupt the process. Over time, a therapist can help individuals learn to challenge the intrusive thoughts and tolerate the anxiety that arises when those thoughts occur. As people realize they can survive this discomfort and replace negative thoughts, they no longer feel compelled to engage in compulsive behavior. CBT is not an overnight fix; it requires regular meetings with a therapist to “coach” you, as well as work on your own to see thought and behavioral changes.

A couple different types of cognitive behavioral therapy work well for people with OCD:

  • Exposure therapy (also called exposure and response prevention, or ERP). This type of therapy involves gradual exposure to things that typically trigger anxiety and compulsive behavior. An individual who is obsessed with germs and normally refuses to handle a doorknob with their bare hand may be encouraged to briefly touch a doorknob with one finger and then refrain from washing their hands for a minute. Over time, the exposure (and time the individual is asked to refrain from their favored compulsion) is increased. Eventually, the individual may be able to open doors normally without feeling compelled to wash.
  • Acceptance and commitment therapy (ACT). In this form of therapy, affected individuals are encouraged to note, but not necessarily act upon, thoughts. Therapists help clients nonjudgmentally notice their thoughts and learn to tolerate anxiety. According to the International OCD Foundation, “ACT focuses on finding a way to allow obsessions and anxiety to come and go without interfering with the way one lives his or her life.”

Medication for Obsessive-Compulsive Disorder

Prescription medication can help many people with obsessive-compulsive disorder. Physicians frequently prescribe antidepressant medicine to patients with OCD because these medicines can also effectively relieve OCD symptoms.

Obsessive-compulsive disorder medicines include:

  • Fluoxetine
  • Sertraline
  • Clomipramine
  • Fluvoxamine
  • Paroxetine

OCD medication should be taken on a consistent basis. It may take weeks to notice an improvement in symptoms. If antidepressant medicine doesn’t help, your physician may prescribe a different medicine or an antipsychotic medication instead.

Other Treatments for Obsessive-Compulsive Disorder

If symptoms persist despite therapy and medication, your healthcare provider may recommend:

  • Deep brain stimulation (DBS), which uses electrodes implanted in the brain to electrically stimulate the brain. DBS is approved by the U.S. Food and Drug Administration (FDA) to treat OCD in adults aged 18 and older who have not responded to medication or therapy.
  • Transcranial magnetic stimulation (TMS), which uses external electromagnetic pulses to stimulate the brain. TMS is noninvasive and FDA-approved to treat OCD in adults ages 22 to 68 who have not improved with medication and therapy.
  • Brain surgery. In severe cases of OCD that have not improved despite treatment, brain surgery may relieve symptoms. Surgery targets parts of the brain thought to be hyperactive in people with OCD. Approximately 50 to 60% of people who undergo brain surgery for OCD experience improvement.

It takes time to effectively treat OCD. Your healthcare provider can help you understand your options and support you as you pursue treatment.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Jun 12
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