most individuals with ocd experience some symptoms of the disorder indefinitely with times of improvement alternating with times of difficulty. treatments include cognitive behavioral psychotherapy behavioral therapies and medications. behavioral therapies for ocd include ritual prevention and exposure therapy. prevention of rituals involves a mental-health professional helping the ocd sufferer to endure longer and longer periods of resisting the urge to engage in compulsive behaviors. exposure therapy is the process by which the individual with ocd is put in touch with situations that tend to increase the ocd sufferer's urge to engage in compulsions then helping him or her resist that urge. cognitive/behavioral therapists help patients change the negative styles of thinking and behaving that are often associated with the anxiety involved with obsessive compulsive disorder. selective serotonin reuptake inhibitors (ssris) are the medications that are most commonly used to treat ocd. these medications increase the amount of the neurochemical serotonin in the brain. (remember that brain serotonin levels are thought to be low in ocd. ) as their name implies the ssris work by selectively inhibiting (blocking) serotonin reuptake in the brain. ssris have fewer side effects than clomipramine an older medication that is actually thought to be somewhat more effective in treating ocd. ssris do not cause orthostatic hypotension (a sudden drop in blood pressure when sitting up or standing) and heart-rhythm disturbances like clomipramine can. therefore ssris are often the first-line treatment for this illness. examples of ssris include fluoxetine (prozac) paroxetine (paxil) sertraline (zoloft) citalopram (celexa) fluvoxamine (luvox) and escitalopram (lexapro). when the improvement that people with ocd experience is not optimal when an ssri is the only medication prescribed the addition of a neuroleptic medication like risperidone (risperdal) olanzapine (zyprexa) or aripiprazole (abilify) can sometimes be helpful. ssris are generally well tolerated and side effects are usually mild. the most common side effects are nausea diarrhea agitation insomnia and headache. however these side effects generally go away within the first month of ssri use. some patients experience sexual side effects such as decreased sexual desire (decreased libido) delayed orgasm or an inability to have an orgasm. some patients experience tremors with ssris. newer often called atypical neuroleptic medications tend to cause fewer side effects than many of the older medications in this class. the most common side effects of atypical neuroleptics include sleepiness dizziness dry mouth and weight gain. sometimes people can be more sensitive to the effects of the sun while taking these medications and therefore should take care to wear adequate sunblock whenever exposed to the sun. less commonly side effects of atypical neuroleptic medications can result in painless although abnormal muscle movements like tremors stiffness and very rarely permanent muscle twitches called tardive dyskinesia. studies on the effectiveness of treatment of ocd in adults have variable results. some indicate that medications response prevention and cbt are equally although only mildly to moderately effective in treating this problem. cognitive behavioral group therapy (cbgt) has also been found to be an effective treatment for ocd. research on treating ocd in children and adolescents suggests that while medications are clearly effective in treating this disorder the improvement that is experienced as a result is quite mild. however clomipramine tends to be more effective than the ssris and the individual ssris tend to be equally effective. as in adults people under 18 years of age tend to improve more significantly when treated with a combination of medication and cbt.
what are the treatments for obsessive compulsive disorder (ocd)?