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For patients with obsessive-compulsive disorder (OCD), combining cognitive-behavioral therapy with selective serotonin reuptake inhibitors (SSRIs) was associated with a greater reduction in symptoms as well as improvement in quality of life, according to a new report published in JAMA Psychiatry.
SSRIs are currently the only medications approved by the U.S. Food and Drug Administration to treat OCD. SSRIs alone provide only a few patients with significant relief from their OCD symptoms. Therefore, practice guidelines recommend adding antipsychotics or cognitive-behavioral therapy which includes exposure and ritual prevention (EX/RP).
Researcher Helen Blair Simpson, MD, PhD, of Columbia University, and colleagues randomized 100 adult patients to receive eight weeks of risperidone (an antipsychotic drug), and 17 twice weekly EX/RP sessions with a therapist or placebo added to SSRIs. The results showed that more patients receiving EX/RP achieved minimal symptoms, and adding EX/RP was superior to adding risperidone or placebo for improving insight, function and quality of life.
“Patients with OCD receiving SSRIs should be offered EX/RP before antipsychotics given EX/RP’s superior efficacy and less negative adverse effect profile,” the study stated.
“As always, more work remains, but the data presented by Simpson and colleagues are intriguing and thought provoking,” concluded the corresponding editorial. "They remind us that there are likely unique aspects of brain function that are differentially targeted by medication and psychotherapeutic approaches. As the neurology of OCD and other disorders are further dissected, we can hope for progress with targeted combined pharmacotherapy and psychotherapy in which rationally designed therapeutics can be fully derived from our understanding of the brain, its dysfunction, and mechanisms of recovery."
Source: MedicalNewsToday, JAMA Psychiatry
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