Selective serotonin reuptake inhibitors (SSRIs) remain the mainstay pharmacological treatment for OCD. They are fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram and escitalopram. In this case, Mrs P was taking escitalopram. However, in contrast with depression, SSRIs treatment in OCD requires higher dosage and the response time is somehow longer. Usually, patient with depression respond to SSRIs within 2-6 weeks whereas patients with OCD take 10-12 weeks of response time (Dougherty, Rauch and Jenike, 2004). Some suggested that addition of low dose antipsychotic agent (eg haloperidol, olanzapine, etc) could augment the mechanism of SSRIs, leading to improvement of OCD symptoms. (Goddard et al., 2008)
Clomipramine is a tricyclic antidepressant which is of seldom use to treat OCD now. This is mainly …show more content…
It has been shown that combination of exposure response prevention therapy and pharmacotherapy (either SSRIs or clomipramine) can significantly improve the outcome of OCD. A meta-analysis of 24 studies concluded that even without pharmacological treatment, exposure-response prevention and cognitive restructuring could improve the symptoms in …show more content…
A research study done by Nuttin et al, 2004, found that long term electrical stimulation of the anterior limbs of the internal capsule improve the core symptoms of OCD. This is further confirmed by Greenberg et al, 2006, who showed similar results in 3 years follow-up of patient undergone deep brain stimulation. However, the evidence in deep brain stimulation is still debatable and its potential adverse effects must be taken into account. Neurosurgery which involves anterior capsulotomy, anterior cingulotomy, limbic leucotomy, etc may be offered to patient who are not responded to conventional therapy (Lopes et al.,
Clomipramine is a tricyclic antidepressant which is of seldom use to treat OCD now. This is mainly …show more content…
It has been shown that combination of exposure response prevention therapy and pharmacotherapy (either SSRIs or clomipramine) can significantly improve the outcome of OCD. A meta-analysis of 24 studies concluded that even without pharmacological treatment, exposure-response prevention and cognitive restructuring could improve the symptoms in …show more content…
A research study done by Nuttin et al, 2004, found that long term electrical stimulation of the anterior limbs of the internal capsule improve the core symptoms of OCD. This is further confirmed by Greenberg et al, 2006, who showed similar results in 3 years follow-up of patient undergone deep brain stimulation. However, the evidence in deep brain stimulation is still debatable and its potential adverse effects must be taken into account. Neurosurgery which involves anterior capsulotomy, anterior cingulotomy, limbic leucotomy, etc may be offered to patient who are not responded to conventional therapy (Lopes et al.,