Treatment of Obsessive Compulsive Disorder (OCD)

The primary treatment approach for most people of OCD will be to start with psychological treatment in the form of Cognitive Behavioural Therapy (CBT). However, for some people where therapy as not proved successful initially, the NICE guidelines recommend additional therapy (CBT with ERP), or a choice of medication in the form of Selective Serotonin Reuptake Inhibitors (SSRI) such as Escitalopram.

Available Brand

Doctors Liked to Read More

What Is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions).

A diagnosis of OCD requires the presence of obsessions and/or compulsions that are time-consuming (more than one hour a day), cause significant distress, and impair work or social functioning

Obsessions

Obsessions are repeated thoughts, urges, or mental images that cause anxiety.

Typical obsessions:

Fear of getting contaminated by people or the environment
Disturbing sexual thoughts or images
Fear of blurting out obscenities or insults
Extreme concern with order, symmetry, or precision
Recurrent intrusive thoughts of sounds, images, words, or numbers
Fear of losing or discarding something important

Compulsions

Compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought.

Typical compulsions:

Excessive or ritualized hand washing, showering, brushing teeth, or toileting
Repeated cleaning of household objects
Ordering or arranging things in a particular way
Repeatedly checking locks, switches, or appliances
Constantly seeking approval or reassurance
Repeated counting to a certain number

What Are the Most Effective Treatments for OCD?

The most effective treatments for OCD are Cognitive Behavior Therapy (CBT) and/or Medication.

The most effective treatments are a type of CBT called Exposure and Response Prevention (ERP), which has the strongest evidence supporting its use in the treatment of OCD, and/or a class of Medications called Selective Serotonin Reuptake Inhibitors, or SSRIs.

What is CBT & SSRI?

Cognitive-Behavioral Therapy

One effective treatment is a type of cognitive-behavioral therapy (CBT) known as exposure and response prevention. During treatment sessions, patients are exposed to feared situations or images that focus on their obsessions, initially leading to increased anxiety.

Patients are instructed to avoid performing their usual compulsive behaviors (known as response prevention). By staying in a feared situation without anything terrible happening, patients learn that their fearful thoughts are just thoughts rather than reality.

Selective Serotonin Reuptake Inhibitors (SSRI)

SSRI medications are usually tried first (before non-selective SRIs) because SSRIs only act on serotonin. The SSRIs usually recommended for the treatment of OCD in the UK are: