Treatment strategies for obsessive-compulsive disorder

Abstract

Importance of the field: In the last decades, the treatment of obsessive-compulsive disorder (OCD) has improved significantly with the introduction into the clinical practice of the selective serotonin reuptake inhibitors (SSRIs): this has led to a renewed interest in this condition and development of appropriate therapeutic strategies, including non-pharmacological techniques.

Areas covered in this review: The aim of this paper is to present a comprehensive and critical review of pharmacological and non-pharmacological treatments usually adopted in the management of OCD. MEDLINE and PubMed (1980 – 2009) databases were searched for English-language articles by using the following keywords: OCD, clomipramine, SSRIs, resistance, predictor of response, cognitive-behavioral therapy, exposure and response prevention, repetitive transcranial magnetic stimulation, deep brain stimulation, neurosurgery, electroconvulsive therapy.

What the reader will gain: The reader will gain an exhaustive review of the advantages and disadvantages of the treatments usually adopted in OCD, with a special focus on resistance and clinical features that can be used as predictors of response.

Take home message: Obsessive-compulsive disorder is a common psychiatric condition that can be adequately managed with the currently available therapeutic options. Although a certain percentage of patients do not achieve complete clinical remission, improvement of some of their core symptoms permits them to live more satisfying lives and to reach a better social adjustment.

Keywords::

• clomipramine
• cognitive-behavioral therapy
• deep brain stimulation
• electroconvulsive therapy
• exposure and response prevention
• neurosurgery
• obsessive-compulsive disorder
• predictor of response
• repetitive transcranial magnetic stimulation
• resistance
• selective serotonin reuptake inhibitors

Notes

This box summarises key points contained in the article.