Obsessive-Compulsive Disorder: Drug Therapy

Therapy target

Improvement of the symptomatology

Therapy recommendations

• Monotherapy with drugs is indicated only if.
  • Cognitive behavioral therapy (CBT) is rejected or, because of the severity of symptoms, no
  • KVT can be performed KVT is not available because of long waiting times or lack of resources or
  • So that the patient’s willingness to engage in further therapy measures (KVT) can be increased.
• Psychopharmacologic therapy for obsessive-compulsive disorder with SSRIs/clomipramine should be combined with CBT with exposures and response management. [Grade of recommendation A]
  • Citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline (selective serotonin reuptake inhibitors, SSRIs).
  • Clomipramine (tricyclic antidepressants), mood-lifting/depression-relieving [second-line drug].
  • Venlafaxine (Selective serotonin-norepinephrine reuptake inhibitors, SSNRI) [second-line drug]
• Note: Behavioral therapy is indicated for obsessive-compulsive disorder (see “Further Therapy” for details). This may involve a steadily increased exposure of triggering causes.