Obsessive Compulsive Disorder

Behavioral therapy

The specific technique used in BT/CBT is called exposure and ritual prevention (also known as "exposure and response prevention") or ERP; this involves gradually learning to tolerate the anxiety associated with not performing the ritual behavior.  The person fairly quickly habituates to the anxiety-producing situation and discovers that their anxiety level has dropped considerably; Exposure ritual/response prevention (ERP) has a strong evidence base. It is generally considered the most effective treatment for OCD.

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Medications

Medications as treatment include selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, sertraline, fluoxetine, escitalopram and fluvoxamine and the tricyclic antidepressants, in particular clomipramine. SSRIs prevent excess serotonin from being pumped back into the original neuron that released it. Instead, serotonin can then bind to the receptor sites of nearby neurons and send chemical messages or signals that can help regulate the excessive anxiety and obsessive thoughts. In some treatment-resistant cases, a combination of clomipramine and an SSRI has shown to be effective even when neither drug on its own has been efficacious

Email: drmongia@ocdconsult.com

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Psychosurgery is a subset of Neurosurgery (surgery of the brain) intended to modulate the performance of the brain, and thus effect changes in cognition, with the intent to treat or alleviate severe mental illness. Despite therapeutic progress in recent years, conventional treatment of anxiety disorders fails or has only a temporary effect in 25 percent of patients. These disorders are often severely disabling and are associated with rates of suicide comparable to those of depression. First described by Leksell, psychosurgery targeting the frontolimbic connections in both anterior internal capsules (capsulotomy) is a valuable therapeutic method for selected severe cases. The first cases using the Gamma Knife to create the lesions were also performed by Leksell .

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Email: drmongia@ocdconsult.com