OCD is treated using medications and psychotherapy.

The first medication considered is usually an antidepressant, which is often effective and lacks severe side effects. These antidepressants are known as selective serotonin reuptake inhibitors (SSRI). They seem effective in treating OCD by increasing the serotonin available in the brain. SSRIs include fluvoxamine (Luvox), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa).

If an SSRI antidepressant is not effective, clomipramine, a tricyclic antidepressant, may be prescribed. Clomipramine, the oldest medication treatment for OCD, is more effective than SSRI antidepressants but has more numerous and unpleasant side effects, including sedation, difficulty starting urination, dry mouth, and a drop in blood pressure when rising from a seated position.

In more resistant cases, an SSRI and clomipramine may be combined. While other medications, such as benzodiazepines, may offer some relief from anxiety, they are generally used only in conjunction with the more reliable treatments.

Psychotherapy, which may occur on an individual basis or in a group setting, is used to reduce anxiety, resolve inner conflicts, and provide effective ways of reducing stress.

Behavioral therapies are often employed and may include:

• Exposure/response prevention: the person is repeatedly exposed to a situation that triggers anxiety symptoms, and learns to resist the urge to perform the compulsion.
• Thought-stopping: the person learns to stop unwanted thoughts and focus attention on relieving anxiety.

OCD is a chronic illness which, like other psychiatric illnesses, has periods of exacerbation followed by periods of relative improvement, though a completely symptom-free interval is generally unusual. With treatment, most sufferers have considerable improvement.

The most likely long-term consequences of OCD are related to the nature of the obsessions or compulsions. For example, constant handwashing can cause skin breakdown. However, OCD does not ordinarily progress into another disease.

Call for an appointment with your health care provider if your obsession is interfering with daily life, work, or relationships. Call if your compulsion is consuming an inordinate amount of time, energy, or resources.