Obsessive-Compulsive Disorder (OCD)
- Armaan R
- Sep 18
- 5 min read
Part Two: How Is It Treated?
Introduction
In my previous post, I provided some insight into OCD’s (1) symptoms, (2) prevalence, and (3) comorbid medical conditions. As a follow-up, I’d like to impart a general overview regarding OCD’s treatment, via a combination of pharmacotherapy and psychotherapy.
Effective treatment for OCD requires a meticulous, comprehensive, and coordinated approach. When possible, I recommend that individuals seek care under the guidance of their physicians (general or psychiatry) and mental health providers (psychologists or therapists).
Pharmacotherapy
**** DISCLAIMER **** The information provided, regarding pharmacotherapy, is not meant to replace the professional expertise of a physician. Any medication taken to address symptoms of OCD, or otherwise, should be done under the firm guidance of a doctor.
As highlighted previously, OCD can be very debilitating, as it can cause substantial anxiety, distress, and interfere with one’s daily functioning. OCD can be treated using a variety of medications.
About 7-10 individuals, with OCD, will benefit from taking medication(s) or Exposure and Response Prevention (ERP), and those that derive benefit from medication can see their symptoms improve as much as 60% (Jenike, n.d.).
Research has shown that Serotonin Reuptake Inhibitors (SRIs) are highly efficacious in treating OCD (IOCDF, 2025.). These medications are utilized as antidepressants; however, they can also be used to treat OCD (Jenike, n.d.).
Please see below for a list of medications that are used to treat OCD (Jenike, n.d.):
As a therapist, I see clients whose symptom severity can vary substantially. However, generally, I find that clients are willing to engage in psychotherapy (Exposure & Response Prevention – ERP) more readily if they are taking medication. Many of my clients also report a noticeable decrease in the (1) frequency, (2) intensity, and (3) duration of their intrusive thoughts and corresponding desire to engage in compulsions (rituals).
SRIs are generally well tolerated and many side effects tend to dissipate as one’s body becomes accustomed to the medication (University of Florida, n.d.). Some common side effects include (1) nervousness, (2) insomnia, (3) nausea, (4) diarrhea, and (5) restlessness (University of Florida, n.d.). Many of my clients cite an improvement in side-effects, as time passes; however, if one does experience any adverse complications from medication, it is best to consult with one’s physician.
Exposure & Response Prevention (ERP)
OCD can be a challenging mental health presentation because it creates a chronic loop of anxiety that is not resolved. Individuals will encounter a trigger that elicits an intrusive thought, and they will employ their compulsive and/or ritualistic behaviors to minimize feelings of anxiety and dread. However, this process does not allow them to habituate and become resilient to their triggers. Furthermore, it validates that their compulsions are required for anxiety reduction.
ERP is a type of cognitive behaviour therapy that breaks OCD’s distressing cycle. ERP entails exposing individuals to their obsession, triggers and fears, in a safe environment, and without letting them engage in compulsive behaviours (OCD-UK, n.d.). The individuals will feel anxious; however, with the support of a therapist, they will learn to tolerate their obsessions and habituate, or become resilient, to the anxiety they elicit (OCD-UK, n.d.).
When I see clients for ERP therapy, we create an exposure hierarchy in which they tackle increasingly intense exposures pertaining to their obsessions. ERP therapy is challenging, as it requires one to confront their fears and obsessions; however, it is very efficacious In anxiety reduction. A variety of exposure techniques are utilized in ERP that include (Tsao et al., 2024):
In-Vivo Exposures – confronting feared triggers, situations, and environments in real life.
Ex. An individual will touch a dirty surface and avoid washing their hands
Fear of contamination
Imaginal Exposures – vividly imagining feared scenarios using written or audio recorded scripts.
Ex. An individual will read a script in which someone was bitten by a snake and received medical treatment
Fear of snakes
Interoceptive Exposures – entails creating physical sensations felt when experiencing anxiety.
Ex. spinning in a chair to create a sense of dizziness, hyperventilating to create shortness of breath, etc.
Inducing such sensations normalizes them and reduces the severity of panic when they are experienced.
Efficacy
There is strong evidence to support the benefits of medication and ERP in addressing, managing, and improving symptoms of OCD. I have briefly highlighted some literature that emphasizes the efficacy of these treatment modalities when treating OCD.
Del Casele et al. (2019) conducted a literature review, and found that SRI’s, in combination with CBT/ERP, is improved symptoms of OCD. Mao et al. (2022) conducted a meta-analysis, comprising 21 studies and 1,113 participants, and they determined that individuals with OCD saw substantial symptom improvement when medication and ERP were combined (more so than medication alone). Ferrando & Selai (2021) conducted a meta-analysis and literature review, comprising 24 studies, and they found that ERP was highly effective in reducing OCD symptom severity.
Conclusion
OCD can be a challenging mental health presentation to manage; however, one does not have to navigate the stressors of OCD alone. Working with a trained physician, and therapist, medication and ERP can be highly efficacious in addressing symptoms, reducing anxiety, and combatting intrusive thoughts and compulsive behavior. In turn, one can live a life that is devoid of the immense stressors imposed by this condition.
References (Sources)
Del Casale, A., Sorice, S., Padovano, A., Simmaco, M., Ferracuti, S., Lamis, D. A., Rapinesi, C., Sani, G., Girardi, P., Kotzalidis, G. D., & Pompili, M. (2019). Psychopharmacological Treatment of Obsessive-Compulsive Disorder (OCD). Current neuropharmacology, 17(8), 710–736. https://doi.org/10.2174/1570159X16666180813155017
Ferrando, C. & Selai, C. A systematic review and meta-analysis on the effectiveness of exposure and response prevention therapy in the treatment of Obsessive-Compulsive Disorder. Journal of Obsessive-Compulsive and Related Disorders. 2021. Vol. 31:100684. DOI: 10.1016/j.jocrd.2021.100684
Jenike, M. (n.d.). Medications for OCD. International OCD Foundation. https://iocdf.org/about-ocd/treatment/meds/.
Mao, L., Hu, M., Luo, L., Wu, Y., Lu, Z., & Zou, J. (2022). The effectiveness of exposure and response prevention combined with pharmacotherapy for obsessive-compulsive disorder: A systematic review and meta-analysis. Frontiers in psychiatry, 13, 973838. https://doi.org/10.3389/fpsyt.2022.973838
Medications for OCD ” Department of Psychiatry ” College of Medicine ” University of Florida. UF monogram. (n.d.). https://psychiatry.ufl.edu/patient-care-services/uf-ocd-anxiety-related-disorders-treatment-program/medications-for-ocd/
OCD-UK. (n.d.). https://www.ocduk.org/overcoming-ocd/accessing-ocd-treatment/exposure-response-prevention/
Tsao, S., Yusko, D., DiChiara, C., Murphy, S. (2024, January 24-26). Obsessive compulsive disorder: Diagnosis, assessment, and treatment with exposure and response prevention. Center for Anxiety Behaviour Therapy. https://www.centerabt.com/
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