'Exposure therapy' along with antidepressants may help with OCD

September 11, 2013 by Randy Dotinga, Healthday Reporter
'Exposure therapy' along with antidepressants may help with OCD
SSRI drugs found effective, but study raps risperidone.

(HealthDay)—New research suggests that patients with obsessive-compulsive disorder do better when they combine intensive "exposure therapy" with an antidepressant rather than taking a common two-drug combination.

There are caveats, however: The kind of used in the study required patients to see therapists twice a week, which can be expensive; some obsessive-compulsive disorder (OCD) patients simply refuse to engage in this kind of therapy; and it's not clear what happens to patients in the long term.

Still, OCD patients who take antidepressants and still have symptoms should try exposure therapy before taking the medications with a drug known as , said study lead author Dr. Helen Blair Simpson, a professor of at Columbia University. "If risperidone is tried, clinicians should know that it is likely to help only a small subset, and it should be discontinued if there is no obvious benefit," she said.

About 1 percent of Americans suffer from OCD. Half of these people are thought to have severe cases, according to the U.S. National Institute of Mental Health.

People with OCD suffer from a variety of compulsions, rituals and obsessions, all of which can disrupt their lives and make them anxious. They may develop elaborate routines to avoid things like germs and become unable to stop their thoughts from racing over the same topic.

Psychiatrists often prescribe antidepressants known as —including Prozac, Paxil and others—to people with OCD. But that's often not enough to help them.

That's where another drug, risperidone (brand name Risperdal), often is used. In some cases, prescribe it in addition to antidepressants because it's thought to help OCD patients. It's known as an antipsychotic drug, although it's used to treat a variety of .

Exposure therapy is a non-drug treatment designed to gradually help OCD sufferers overcome their fears by slowly exposing them to the things that scare them.

The new study aimed to find out if the works—and also if it's better than antidepressants and exposure therapy.

Over five years, ending in 2012, researchers randomly assigned 100 adult OCD patients—all of whom already were taking antidepressants—to add risperidone or a placebo or take part in 17 twice-weekly sessions of exposure therapy. Fourteen patients dropped out, leaving 86 total.

After two months, 43 percent of patients who took an antidepressant plus exposure therapy had minimal symptoms of OCD, compared with 13 percent who added risperidone and 5 percent who took a placebo.

Side effects were more common among those who took risperidone.

"Some OCD patients won't do exposure therapy," Simpson said. "Some won't take medications, especially antipsychotic medications. For a study like this, patients had to be open to either treatments."

Paul Salkovskis, an OCD specialist and a professor of clinical psychology and applied science at the University of Bath, in England, praised the study and said the findings confirm that risperidone doesn't help OCD patients, while exposure and cognitive behavioral therapy "has a substantial effect."

"It's about as strong a study as can be—properly conducted, properly reported and analyzed. It is world-changing for OCD ," Salkovskis said. "People should be helped by their doctor to discontinue risperidone as soon as possible. The other implication is that there is an urgent need to make cognitive behavior therapy more available."

The study appears online Sept. 11 in the journal JAMA Psychiatry.

Explore further: The difference between obsession and delusion

More information: For more about obsessive-compulsive disorder, try the U.S. National Library of Medicine.

Simpson HB, Foa, EB, Liebowitz MR, Huppert JD, Cahill S, Maher MJ, McLean CP, Bender Jr. J, Marcus SM, Williams MT, Weaver J Vermes D, Van Meter PE, Rodriquez CI, Powers M, Pinto A, Imms P, Hahn C-G, Campeas R. Cognitive-Behavioral Therapy vs Risperidone for Augmenting Serotonin Reuptake Inhibitors in Obsessive-Compulsive Disorder – A Randomized Clinical Trial. JAMA Psychiatry, Sept. 11, 2013.

Ressler, KJ, Rothbaum BO. Augmenting Obsessive-Compulsive Disorder Treatment – From Brain to Mind. JAMA Psychiatry, Sept. 11, 2013.

Related Stories

The difference between obsession and delusion

September 4, 2013
Because animals can't talk, researchers need to study their behavior patterns to make sense of their activities. Now researchers at Tel Aviv University are using these zoological methods to study people with serious mental ...

Surgery for obsessive compulsive disorder sufferers is safe and effective

June 3, 2013
Around half of people with an extreme form of obsessive compulsive disorder responded well to a type of psychosurgery that proved to be safe and effective, according to research published online in the Journal of Neurology, ...

New research provides insight into how obsessive-compulsive disorder develops

May 23, 2011
(Medical Xpress) -- New scientific evidence challenges a popular conception that behaviours such as repetitive hand-washing, characteristic of obsessive-compulsive disorder (OCD), are carried out in response to disturbing ...

Scientists pinpoint how deep brain stimulation eases OCD

February 24, 2013
(HealthDay)—Deep brain stimulation has helped people with severe obsessive-compulsive disorder, and new research begins to explain why.

AANS: Stereotactic anterior cingulotomy viable for OCD

April 17, 2012
(HealthDay) -- Most people with obsessive-compulsive disorder manage their symptoms through talk therapy and medication. But for some, severe OCD can take over their lives. A few eventually turn to brain surgery, and a new ...

Recommended for you

Exposure to violence hinders short-term memory, cognitive control

July 24, 2017
Being exposed to and actively remembering violent episodes—even those that happened up to a decade before—hinders short-term memory and cognitive control, according to a study published in the Proceedings of the National ...

Using money to buy time linked to increased happiness

July 24, 2017
New research is challenging the age-old adage that money can't buy happiness.

Researchers pave new path toward preventing obesity

July 24, 2017
People who experience unpredictable childhoods due to issues such as divorce, crime or frequent moves face a higher risk of becoming obese as adults, according to a new study by a Florida State University researcher.

Higher cognitive abilities linked to greater risk of stereotyping

July 24, 2017
People with higher cognitive abilities are more likely to learn and apply social stereotypes, finds a new study. The results, stemming from a series of experiments, show that those with higher cognitive abilities also more ...

Psychologists say our 'attachment style' applies to social networks like Facebook

July 24, 2017
A new investigation appearing this week in the Personality and Social Psychology Bulletin suggests a strong association between a person's attachment style—how avoidant or anxious people are in their close relationships—and ...

World-first ketamine trial shows promise for geriatric depression

July 24, 2017
Australian researchers have completed the world's first randomised control trial (RCT) assessing the efficacy and safety of ketamine as a treatment for depression in elderly patients.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.