Treatment Strategies for Chronic and Refractory Obsessive-Compulsive Disorder
Steven A. Rasmussen, M.D., and Jane L. Eisen, M.D.
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Obsessive-compulsive disorder (OCD), despite our increasing understanding of its causes and its
effective treatment, remains a chronic and underdiagnosed disorder. Both treatment with SSRIs and
the behavioral treatment strategy of exposure with response prevention have been proved by clinical
trials to be effective and safe in treating OCD; however, even these treatments sometimes elicit only
moderate patient response, and some OCD patients do not respond to them at all. Preliminary data
suggest that OCD has lifelong persistence and that discontinuation of pharmacotherapy often leads to
relapse. Nonetheless, further prospective, controlled, maintenance studies of OCD are needed to determine
factors in and predictors of recovery, remission, and relapse. Finally, new procedures for
treatment-refractory patients are needed; neurosurgical and new pharmacologic approaches have
shown promise in treating these patients and should be studied in controlled trials.
J Clin Psychiatry 1997;58(suppl 13):9–13
© Copyright 1997 Physicians Postgraduate Press, Inc.
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