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OCD Medication and Psychotherapy

Abstract: The combination of medication and Cognitive Behaviour Therapy is effective for the treatment of Obsessive-Compulsive disorder.

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OCD Medication and Psychotherapy

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Question(s): 
Written by: Dr. Martin Winkler
First version: 22 Jul 2008.
Latest revision: 23 Aug 2008.

Which treatment is best for Obsessive-Compulsive disorder? Are medicines enough in the treatment of Obsessive-Compulsive disorder?

Answer:

Medication, as well as psychotherapeutic treatment, can be effective for the Obsessive-Compulsive Disorder - OCD (compulsive acts and obsessive thoughts). There are advantages and disadvantages with both, but a combination gives the best results.

Among medicines, the ones affecting the system that regulates the serotonin in our brains and are otherwise used in the treatment for depression, have shown to be particularly effective. The SSRIs and the somewhat older antidepressive Clomipramin belong to this kind of medicines.

Cognitive Behavior Therapy with exposure exercises is considered to be successful in the treatment of Obsessive-Compulsive disorder (i.e. the patient is exposed to his/her obsession and the practice of the compulsive acts is prevented).

In clinical practice today a combination of psychotherapy and medication is usually offered. A small clinical study in Spain examined the effects of this kind of treatment with 20 patients suffering from an Obsessive-Compulsive disorder. The patients had psychotherapy (Cognitive Behaviour Therapy over 12-24 months) and/or a treatment with a SSRI or Clomipramin. With the combined treatment the psychotherapy usually started after 2. or 3. visits and continued until the medication ended.

The study showed that the type of the treatment had an influence on the test results. From the 10 patients, who were treated with medication, 8 had a relapse. With the combination of medication and psychotherapy, only one patient had a relapse. Also the time up to the relapse (renewed occurrence of the Obsessive-Compulsive disorder) was clearly longer for the group of combined treatment with 132 months, compared to 25 months for the group on medication.

This small study therefore speaks for the fact that the best results are obtained with a combination of medication and psychotherapy for the treatment of the Obsessive-Compulsive disorder.

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