Abstract and Keywords
This chapter examines how obsessive-compulsive disorder (OCD) may be effectively treated using biologic approaches. Early recognition and intervention with combined cognitive behavioral and medication therapy limit its subsequent morbidity. Selective serotonin reuptake inhibitors (SSRIs) and clomipramine are central in acute and maintenance pharmacotherapy of OCD, often requiring high dosage. Augmenting agents include low-dose typical and atypical antipsychotic agents, among others. As OCD appears to be a chronic waxing and waning illness, effective medications should be continued for at least 1 to 2 years. Relapse rates tend to be high following medication discontinuation, although a history of cognitive behavioral therapy limits this risk. In severe treatment-refractory cases, surgical and somatic therapies such as deep brain stimulation have been used.
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