Updated by Natan Schleider, M.D. on February 27th, 2021
What is OCD and what OCD Treatment in NYC is right for you?
These obsessions and compulsions like OCD cleaning, OCD hand washing, or obsessve cheching of the internet for medical symptoms interferes with daily activities and causes significant distress.
OCD patient worry about getting contaminated by germs. Thy may compulsively wash hands until they’re sore and chapped.
If you have OCD, don’t be ashamed, so do roughly 3 million other Americans!
That’s why OCD doctors are here to help.
Obsessive-compulsive disorder usually includes both ‘obsessions’ and ‘compulsions,’ it’s also possible to have only obsession symptoms or only compulsion symptoms.
Fear of contamination or dirt
Doubting and having difficulty tolerating uncertainty
Needing things orderly and symmetrical
Aggressive or horrific thoughts about losing control and harming yourself or others
Unwanted thoughts, including aggression, or sexual or religious subjects
Examples of obsession signs and symptoms include:
OCD Treatment in NYC begins with education our patient about what to look out for when OCD is suspected.
OCD usually begins in the teen or young adult years, but it can start in childhood.
Symptoms usually begin slowing and tend to vary in severity throughout life.
The types of obsessions and compulsions you experience can also change over time.
Symptoms generally worsen when you experience greater stress. OCD, usually considered a lifelong disorder, can have mild to moderate symptoms or be so severe and time-consuming that it becomes disabling.
HOW WE OFFER OCD CARE IN NEW YORK CITY:
1.Medications: the first-line medications used for OCD are the Selective Serotonin Reuptake Inhibitors (SSRIs).
2. Cognitive Behavioral Therapy: a specific type of Cognitive Behavioral Therapy known as Exposure and Response Prevention (ExRP) is the most evidenced-based form of therapy for the treatment of OCD.
The first-line medications used to treat OCD are the Selective Serotonin Reuptake Inhibitors (SSRIs).
The doses used to treat OCD are typically higher than those used to treat depression and anxiety disorders. The SSRIs FDA approved for OCD are in bold although many SSRIs can be used to treat OCD:
It does not appear that any SSRI works better than any other for the treatment of OCD. However, some people will respond to one SSRI and not respond to another, but currently we are not able to predict which SSRI a given person will respond to and which SSRI he or she may not respond to.
When given an SSRI, 40–60% of patients with OCD symptoms will respond. Those who respond will have an average of a 20–40% decrease in OCD symptoms.
We will usually try a different SSRI. One review showed that up to 33% of patients with OCD symptoms who did not respond to the first SSRI will respond to the second SSRI.
The first medication found to successfully treat OCD was Clomipramine (Anafranil). This is an older medication than the SSRIs from a class of medications called Tricyclic Antidepressants (TCAs). Clomipramine is the only one of the TCAs that has proven to be effective for OCD.
While meta-analyses suggest greater efficacy for Clomipramine than for SSRIs, results of head-to-head trials do not support this impression and suggest that SSRIs and Clomipramine are equally effective. Given that SSRIs have a less troublesome side effect profile than Clomipramine, SSRIs are preferred for a first medication trial. If a patient does not respond to several SSRIs, we will often try Clomipramine because we sometimes see patients respond to Clomipramine who did not respond to SSRIs.
weight gain (except Lexapro which is weight neutral)
Yes, Cognitive Behavioral Therapy and Exposure and Response Prevention (ERP) can help improve OCD.
Exposure and response prevention [Source: Wikipedia article on ERP also called Exposure and Response Therapy]
In the exposure and response prevention (ERP or EX/RP) variation of exposure therapy, the goal is to prevent OCD patients from obsessing and compulsing ALL THE TIME both with OCD care in New York City Doctor offices but OUTSIDE THE OFFICE as well. The American Psychiatric Association recommends ERP for the treatment of OCD, citing that ERP has the richest empirical support.
While this type of therapy typically causes some short-term anxiety, this facilitates long-term reduction in obsessive and compulsive symptoms.[Generally, ERP incorporates a relapse prevention plan toward the end of the course of therapy.