treatment refractory ocd
Refractory Obsessive-Compulsive DisorderPsychiatric Times
· Treatment-resistant OCD The definition of treatment-resistant OCD hinges on the non-response to 2 therapeutic trials of SSRIs/clomipramine while treatment-refractory may imply greater degree of resistance to interventions including non- respond to SSRIs/clomipramine augmentation strategies and behavioral interventions (Figure).
Get PriceA Review of the Treatment for Refractory Obsessive
· The subject of treatment-resistant and treatment-refractory OCD is the discussed including a definition of these often-debated terms and the latest treatment options delineated. This includes a review of the latest research concerning the pharmacological agents that have been studied as monotherapy or augmenting agents for the treatment of
Get PriceNeurosurgery for the treatment of OCD OCD-UK
Although the term treatment refractory is a controversial one and not a term OCD-UK like to use. The NICE Guidelines for the treatment of OCD are quite clear neurosurgery is not recommended at this time Neurosurgery is not recommended in the treatment of OCD. NICE 2005. However there continues to be some doctors that think
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· treatment refractory ocd Approximately 25 of all OCD patients will be classified as treatment-resistant this is defined as failing two different SSRI courses. Furthermore 40-60 of all patients may be considered as responding positively to treatment but
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· 2. Treatment of OCD patients refractory to serotonergic antidepressants. Although SSRIs and clomipramine have proven efficacy in OCD about 40 to 60 of patients show no or just partial symptom improvement to a treatment with a first-line drug .The large fraction of patients without substantial response to standard treatment experiences significant morbidity .
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· Neurosurgical approaches to treatment-refractory OCD have recently been reviewed. 36 86 Briefly several different neurosurgical lesion approaches using a variety of techniques (including standard craniotomy implantation of radioactive seeds for local ablation and gamma knife coagulative lesions) have shown some efficacy in open trials of
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· Pediatric OCD trials of paroxetine and sertraline have demonstrated a poorer response in children with comorbid tics. 41 Meta-analysis of antipsychotic augmentation trials in adults with treatment-refractory OCD suggests that OCD patients with comorbid tics are significantly more likely to respond to this intervention. 42 The NNT for response
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fied treatment regimen is successful. In this paper habit reversal training including awareness training competing/other response training self-monitoring social support and generalisation was implemented with a long-term treatment-refractory OCD patient. Treatment gains and long-term maintenance indicate
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· five OCD treatment outcome studies by Fisher Wells (2005) and comparable to the severe OCD outpatient treatment baseline severity reported by Boschen et al. (2008). This combined with the requirement that previous treatment had been unsuccessful supports the assertion that our sample was one with severe and refractory OCD prior to treatment.
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· an open-label trial in treatment refractory OCD patients 19 . An open-label study on aripiprazole has shown some positive response 20 . However these studies are too preliminary for clinical application. By far the majority of antipsychotic stud-ies in OCD have been as an augmentation strategy for SSRIs.
Get PriceStrategies for Treatment-Resistant OCDPsychiatric Times
First-line treatments for OCD are SSRIs and the exposure and response prevention model of cognitive-behavioral therapy (CBT). However effect sizes are not remarkable pharmacotherapy rates range from 0.37 to 1.09 CBT rates range from 0.99 to 1.13. 2 3. Many OCD patients do not respond adequately to
Get Price1 Guidance Obsessive-compulsive disorder and body
· 1.6.1.1 People with severe chronic treatment‑refractory OCD or BDD should have continuing access to specialist treatment services staffed by multidisciplinary teams of healthcare professionals with expertise in the management of the disorders.
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· an open-label trial in treatment refractory OCD patients 19 . An open-label study on aripiprazole has shown some positive response 20 . However these studies are too preliminary for clinical application. By far the majority of antipsychotic stud-ies in OCD have been as an augmentation strategy for SSRIs.
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· refractory OCD symptoms as illustrated in this case report. CASE PRESENTATION. Mr. S is a 32-year-old single Caucasian gentleman with 12-year history of treatment-refractory chronic OCD characterized . by multiple obsessions and compulsions. His obsessions were related to excessive fears of being contaminated by unseen
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· Treatment refractory OCD can be determined if a person has tried at a minimum three different SSRIs (Clomipramine one among them) at a maximum dosage for at least 3-6 months along with the behavioural therapy together in conjunction with a trial of
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· In patients who have not responded to an anti-OCD medication or whose response has been inadequate (about 40 of any large series of patients) the clinician can consider adding one of the following drugs risperidone 0.5-6.0 mg/day buspirone 60-90 mg/day olanzapine 2.5-20 mg/day (weight gain is a problem) trazodone mg/day or L-tryptophan 2 gm twice daily plus pindolol 2.5 mg
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Pharmacotherapy for Treatment-Resistant Obsessive-Compulsive Disorder. Reilly R. Kayser MD a b . O bsessive-compulsive disorder (OCD) is a disabling illness affecting approximately 2 -3 individuals worldwide that is marked by recurrent distressing intrusive thoughts (obsessions) and repetitive behaviors (compulsions). 1 2 The underlying
Get PriceLimbic system surgery for treatment-refractory obsessive
treatment-refractory OCD. Other effective stereotactic ablative procedures within the limbic system include an-terior capsulotomy 17 25 subcaudate tractotomy 16 and lim-bic leukotomy 13 14 which is a combination of cingulotomy and subcaudate tractotomy.
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· In this context adding an antipsychotic medication to ongoing treatment is used as a strategy for refractory OCD patients. In addition tramadol a μ opioid receptor agonist and an inhibitor of serotonin and norepinephrine transporters was reported to be efficacious in
Get PriceHabit reversal training as a treatment for refractory OCD
fied treatment regimen is successful. In this paper habit reversal training including awareness training competing/other response training self-monitoring social support and generalisation was implemented with a long-term treatment-refractory OCD patient. Treatment gains and long-term maintenance indicate
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· Purpose of review Many individuals with obsessive-compulsive disorder (OCD) do not fully respond to first-line treatments (psychotherapy consisting of exposure and response prevention EX/RP and serotonin reuptake inhibitor SRI pharmacotherapy). These cases are often considered "treatment-resistant" OCD. In this article we offer a heuristic guide for treating clinicians for such cases.
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· refractory OCD symptoms as illustrated in this case report. CASE PRESENTATION. Mr. S is a 32-year-old single Caucasian gentleman with 12-year history of treatment-refractory chronic OCD characterized . by multiple obsessions and compulsions. His obsessions were related to excessive fears of being contaminated by unseen
Get PriceTreatment-Resistant Obsessive-Compulsive Disorder (OCD
· 2. Treatment of OCD patients refractory to serotonergic antidepressants. Although SSRIs and clomipramine have proven efficacy in OCD about 40 to 60 of patients show no or just partial symptom improvement to a treatment with a first-line drug .The large fraction of patients without substantial response to standard treatment experiences significant morbidity .
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· Notably subjects were treatment-resistant in both this and the Sachdev study. Thus although this limited literature precludes any definitive conclusions it suggests that rTMS may be of benefit in refractory OCD. In this study we propose to investigate the effectiveness of rTMS treatment in refractory OCD.
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· A decrease in cortical inhibition has been implicated in OCD utilizing a variety of methods including paired-pulse TMS. First-line treatment typically consists of either cognitive-behavioural therapy and/or pharmacotherapy with serotonin reuptake inhibitors (SSRI s or clomipramine).
Get PriceLimbic system surgery for treatment-refractory obsessive
treatment-refractory OCD. Other effective stereotactic ablative procedures within the limbic system include an-terior capsulotomy 17 25 subcaudate tractotomy 16 and lim-bic leukotomy 13 14 which is a combination of cingulotomy and subcaudate tractotomy.
Get PriceA Review of the Treatment for Refractory Obsessive
· The subject of treatment-resistant and treatment-refractory OCD is the discussed including a definition of these often-debated terms and the latest treatment options delineated. This includes a review of the latest research concerning the pharmacological agents that have been studied as monotherapy or augmenting agents for the treatment of
Get PriceEvidence-based pharmacotherapy of obsessive-compulsive
Selvi et al. demonstrate superiority of risperidone over aripiprazole as adjunctive treatment in OCD patients who failed to respond to 12 wk of treatment with SSRI. Refractory patients (n=41) were randomized to receive either risperidone (3 mg/d n=20) or aripiprazole (15 mg/d n=21) in addition to continuing SSRI. Of the risperidone group 13
Get PriceCommunity treatment of severe refractory obsessive
The study reports on the results of a community treatment service for individuals with treatment-refractory OCD who have not benefitted from previous cognitive behavioural or pharmacological treatment by community mental health services. A total of 205 individuals accepted for treatment by a specialist community OCD treatment service in London
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