Standard treatment includes drug therapy, behavior therapy, or a combination of both. Research has shown that a combination of medication and behavior therapy is most effective in treating OCD.
Medications in two different categories are available to treat OCD, including one of the tricyclic antidepressants (Anafranil) and several of the selective serotinin reuptake inhibitors, or SSRIs (such as Prozac, Luvox, and Zoloft). These medications help increase the brain's balance of serotonin -- a chemical linked to OCD.
Behavior therapy teaches people with OCD to confront their fears and reduce the anxiety without performing the rituals. This should not be confused with other types of therapies that involve talking about one's past, such as psychoanalysis or insight based therapy.
Modern treatment interventions like cognitive and behavioral therapy show promising results . Behavioral therapy (BT) is as effective as pharmacotherapy (medications) in OCD (Van Balkom et al., 1998), and some data indicate that the beneficial effects are longer-lasting with behavior therapy . About two-thirds of patients with moderately severe rituals can be expected to improve substantially, but not completely.A combination of BT and pharmacotherapy might constitute the optimal treatment for OCD. Two recent neuroimaging studies found that patients with OCD who are successfully treated with BT show changes in cerebral metabolism similar to those produced by successful treatment with SRIs . BT can be conducted in inpatient and outpatient settings.
The principal behavioral approaches in OCD are exposure for obsessions and response prevention for rituals. In BT the patient must collaborate and carry out assignments. In a study with 18 OCD patients, patients receiving exposure and response prevention showed significant improvement, whereas patients on a general anxiety management intervention (control) showed no improvement from baseline . Direct comparisons of BT and pharmacotherapy are few and are limited by methodological issues.