Dual Psychotherapies Can Ease OCD When Drugs Fail

New research suggests a treatment regimen that combines exposure and response prevention therapy can help patients with obsessive-compulsive disorder (OCD) when common drug treatment options fail.

Exposure and response prevention therapy is a type of cognitive-behaviora; therapy in which the patient is asked to confront triggers that give rise to their obsessions in order to refrain from performing the rituals in response to these obsessions.

The study is published in the Journal of Clinical Psychiatry.

OCD is marked by the performing of “rituals” to decrease distress related to one’s obsessions, such as excessive hand-washing to cope with a fixation on hand hygiene, for example.

“We know that exposure and response prevention therapy (EX/RP) can benefit these patients,” said lead author Carmen McLean, Ph.D., an assistant professor of clinical psychology at the Perelman School of Medicine — University of Pennsylvania.

Traditional treatment regimens often combine pharmacological treatment and exposure therapy/response prevention therapy for people with OCD.

“But this study showed that EX/RP is also effective for OCD sufferers who do not benefit sufficiently from common drug treatments for OCD.”

A previous study compared the effects of adding risperidone, pill placebo, and up to 17 twice-weekly therapist-led sessions of EX/RP to medication for OCD.

“We found compared to patients who received medication or placebo, those who received EX/RP showed significantly more reductions in OCD symptoms and depression, as well as significantly more increases in insight, quality of life, and social function after only eight weeks,” McLean said.

The current study included 32 patients who crossed over to receive 17 weeks of EX/RP treatment after not benefitting sufficiently from risperidone.

Evaluation at 12 and 16 weeks showed significant symptom improvement, with 25 (78 percent) of patients completing treatment; 17 (53 percent) of them were classified as treatment responders and 11 (34 percent) classified as excellent responders at a 32-week follow-up evaluation.

The remaining patients required medication changes during the follow-up period, which enabled them to shift to excellent-responder status.

This study adds to the large body of research that shows the benefits of exposure therapy for patients with OCD.

“We want patients to know that there is another option, if common drug treatments have failed them,” said senior author Edna Foa, Ph.D., professor of clinical psychology in the department of psychiatry and the creator of exposure therapy.

“The therapy can be life-saving, if patients are aware of it.”

Source: University of Pennsylvania
Man in therapy photo by shutterstock.