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'Exposure Therapy' for OCD

SSRI drugs found effective, but study raps risperidone
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WebMD News from HealthDay

By Randy Dotinga

HealthDay Reporter

WEDNESDAY, Sept. 11 (HealthDay News) -- New research suggests that patients with obsessive-compulsive disorder do better when they combine intensive "exposure therapy" with an antidepressant rather than taking a common two-drug combination.

There are caveats, however: The kind of exposure therapy used in the study required patients to see therapists twice a week, which can be expensive; some obsessive-compulsive disorder (OCD) patients simply refuse to engage in this kind of therapy; and it's not clear what happens to patients in the long term.

Still, OCD patients who take antidepressants and still have symptoms should try exposure therapy before taking the medications with a drug known as risperidone, said study lead author Dr. Helen Blair Simpson, a professor of clinical psychiatry at Columbia University. "If risperidone is tried, clinicians should know that it is likely to help only a small subset, and it should be discontinued if there is no obvious benefit," she said.

About 1 percent of Americans suffer from OCD. Half of these people are thought to have severe cases, according to the U.S. National Institute of Mental Health.

People with OCD suffer from a variety of compulsions, rituals and obsessions, all of which can disrupt their lives and make them anxious. They may develop elaborate routines to avoid things like germs and become unable to stop their thoughts from racing over the same topic.

Psychiatrists often prescribe antidepressants known as selective serotonin reuptake inhibitors -- including Prozac, Paxil and others -- to people with OCD. But that's often not enough to help them.

That's where another drug, risperidone (brand name Risperdal), often is used. In some cases, psychiatrists prescribe it in addition to antidepressants because it's thought to help OCD patients. It's known as an antipsychotic drug, although it's used to treat a variety of mental illnesses.

Exposure therapy is a non-drug treatment designed to gradually help OCD sufferers overcome their fears by slowly exposing them to the things that scare them.

The new study aimed to find out if the drug combination works -- and also if it's better than antidepressants and exposure therapy.

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