Treatment in obsessive–compulsive disorder

Abstract

ABSTRACT Background: Obsessive-compulsive disorder (OCD) is characterised by affective and cognitive symptoms that impair overall functioning and cause psychological discomfort. Due to the use of medical services, these entail high societal costs. Objective: Our goal was to provide a thorough overview of this topic while evaluating the effectiveness of pharmacological therapies in OCD and clinical recommendations. Methods: We looked for papers on the use of drugs to treat OCD in the pubmed database, with an emphasis on clinical guidelines, the use of antidepressants, antipsychotics, mood stabilisers, off-label drugs, and pharmacogenomics. Results: Selective serotonin reuptake inhibitors (SSRIs) work best when taken for a lengthy period of time. A SSRI combination with cognitive behavioural therapy (CBT) or the similarly orientated exposure and response prevention (ERP) can produce better outcomes. Treatment options for refractory OCD include switching to a different SSRI or clomipramine or supplementing with an atypical antipsychotic. Further research is necessary because there is conflicting information about the use of antidepressants intravenously or in addition to antipsychotics. Treatment customization and pharmacogenomics may lessen treatment resistance. Conclusions: When compared to each treatment separately or to other treatments, SSRI/clomipramine combined with CBT/ERP produces the best results. For refractory OCD, new approaches are required. In the upcoming years, pharmacogenomics may play a more significant role.