![]() The most effective treatment for OCD is cognitive behavioural therapy (CBT).Ĭognitive behavioural therapy (CBT) helps you manage your problems by changing your patterns of thinking and behaviour. ![]() One or both of these may be best for you. medicine - usually an antidepressant, to change the balance of chemicals in your brain.psychological therapy - helps you understand OCD and learn new ways of coping.You and your healthcare professional can talk about this and agree on the right treatment options for you. The type of treatment will depend on your own situation and circumstances. Along with deep brain stimulation, ablative neurosurgery should only be performed at sites with expertise in treating OCD with this approach.Obsessive compulsive disorder (OCD) is a treatable condition. Patients with severe and treatment-refractory OCD may consider ablative neurosurgery, although it is rarely indicated. Patients who are severely resistant to treatment may benefit from intensive residential treatment or partial hospitalization. Other less well-supported monotherapies include dextroamphetamine (Dextrostat), tramadol (Ultram), monoamine oxidase inhibitors, ondansetron (Zofran), transcranial magnetic stimulation, and deep brain stimulation. If the SSRI is augmented with clomipramine, the physician should use precautions to prevent cardiac and central nervous system side effects. Morphine sulfate is not recommended for patients with contraindications to opiate administration. These strategies include augmenting SSRIs with clomipramine, buspirone (Buspar), pindolol (Visken), riluzole (Rilutek), or once-weekly oral morphine sulfate. If first- and second-line treatments are unsuccessful, other strategies may be tried, although they are less well-supported. To minimize sexual side effects, the physician should reduce the dosage of the SSRI, wait for symptoms to abate, encourage a weekly one-day break from the medication before sexual activity, prescribe an alternative SSRI, or add a pharmacologic agent such as bupropion (Wellbutrin). Managing medication side effects involves several strategies, including gradually titrating the initial dosage to reduce the possibility of gastrointestinal distress, prescribing a sleep-promoting medication to minimize insomnia, prescribing a modest dosage of modafinil (Provigil) to minimize fatigue, and prescribing a low-dose anticholinergic to minimize sweating. Older patients should use a lower starting dosage, and any increase should be gradual and monitored for side effects. For patients who take a higher dosage, it is important to monitor for side effects, including the serotonin syndrome. Higher dosages may be appropriate for those who tolerate the medication well and have had little response to the treatment. If the patient's response to the treatment is inadequate, trial data suggest that higher SSRI dosages produce a somewhat higher response rate and greater relief of symptoms. The physician should discuss the risks and benefits with the patient. There may be risks associated with taking a psychotropic medication during pregnancy or while breastfeeding. Combined treatment is recommended for patients who have not responded to monotherapy, those with concomitant psychiatric conditions that respond to SSRIs, and those who want to limit the duration of the SSRI treatment. Patients who dislike medications and who are not too depressed or anxious may benefit from CBT (i.e., exposure and response prevention) alone. An SSRI alone is recommended for patients who have previously responded well to a given drug or who are unable to cooperate with CBT. The physician should choose whether to use one or both of these treatments based on several conditions, including the nature and severity of the patient's symptoms, current medications, treatment history, and the availability of CBT. Selective serotonin reuptake inhibitors (SSRIs) and CBT are recommended as safe and effective first-line treatments ( Figure 1). When beginning a treatment for OCD, the physician should consider the patient's motivation and ability to comply with pharmacotherapy and psychotherapy.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |