OCD is treated using medications and psychotherapy.
The first medication considered is usually an SSRI antidepressant, since these are often effective and do not have severe side effects. SSRIs, or selective serotonin reuptake inhibitors, treat OCD by increasing the serotonin available in the brain. They include fluvoxamine (Luvox), fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil).
If an SSRI antidepressant is not effective, clomipramine, a tricyclic antidepressant, may be prescribed. Clomipramine, the oldest medication treatment for OCD, is more effective than SSRI antidepressants but has more numerous and unpleasant side effects, including sedation, urinary retention (difficulty initiating urination), orthostatic hypotension (drop in blood pressure when rising from a seated position), and dry mouth.
In more resistant cases, an SSRI and clomipramine may be combined. While other medications, such as benzodiazepines, may offer some relief from anxiety, they are generally used only in conjunction with the more reliable treatments.
Psychotherapy, which may occur on an individual basis or in a group setting, is used to reduce anxiety, resolve inner conflicts, and provide effective ways of reducing stress.
Behavioral therapies are often employed and 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.
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