Obsessive Compulsive Disorder (OCD)

Last updated 25.08.13

Definition

-     

 

Features

-    High rate of relapse

-    Common comorbidities

-      Depression

-      Social phobia

-      Substance abuse

-      Suicidal ideation

 

Ix

-      Y-BOCS Scale (symptom severity)

 

Mx

-      Mild to Moderate

-     CBT

-    If no improvement then consider SSRI

-     Or SSRI +/- CBT

-      Severe

-     Refer to Psychiatrist

-     CBT

-     SSRI

-     If inadequate response

-    Consider new SSRI

-    Consider: Venlafaxine or Mirtazapine

-    +/- Atypical Antipsychotic

-      SSRI

-     Often require high dose

-     Increase over 4-6 weeks

-     Longer time to respond than for other idications

-     Usually 2yrs+ treatment

-     Fluoxetine

-    Start at 20mg Daily

-    Aim for 40-60mg Daily

-     Paroxetine

-    Start at 20mg Daily

-    Aim for 40-60mg Daily

-     Sertraline

-     Escitalopram

-    Start at 10mg Daily

-    Aim for 20mg Daily

 

 

 

References