Clinical practice guidelines for Obsessive-Compulsive Disorder

Recommendations are summarized in Table 14. The SSRIs and CBT are the first-line treatment options for OCD. CBT alone may be tried in mild to moderately ill patients if facilities for CBT are available. In severe OCD, a combination of SSRI and CBT is recommended. In the Indian context, SSRIs are the preferred first-line treatment for OCD because of limited resources for delivering CBT. SSRIs are effective, well tolerated and safe. For partial responders and nonresponders to SRIs, CBT is an effective augmenting agent followed by atypical antipsychotics. Although an attempt may be made to taper and stop SSRI after 1-2 years of sustained remission, most patients may require indefinite continued treatment with a SSRI. DBS and ablative surgery may be considered in chronic, severe OCD if other established treatment options have failed to produce any clinically significant improvement. © 2017 Indian Journal of Psychiatry | Published by Wolters Kluwer-Medknow.