... People with OCD experience unwelcome thoughts, known as obsessions, and feel compelled to perform repetitive behaviors, or compulsions. Risperidone Falls Short Compared to EX/RP After eight weeks of treatment, 80 percent of patients receiving EX/RP experienced symptom improvement (defined as at least a 25 percent reduction in symptoms). Individuals with this condition have recurrent thoughts, images, or urges, known as 'obsessions,' which provoke distress. This form of therapy involves helping the individual confront feared situations without engaging in compulsions in a systematic fashion. © Copyright OCD Action. For individuals who continue to have significant OCD symptoms despite an adequate trial of an SRI, current psychiatric practice guidelines recommend adding an additional treatment, which psychiatrists refer to as SRI augmentation. We asked David Veale, one of the Charity’s trustees, to comment“The paper describes a controlled trial in which 100 people with OCD who had received a SSRI medication for at least 3 months and had moderate OCD symptoms were randomized to receive either (A) risperidone (an antipsychotic) or (B) Pill placebo or (C) Cognitive Behavioural Therapy over 17 sessions. © 1999-2020 Consumer Brands LLC, ALL RIGHTS RESERVED Drugs like risperidone are not recommended unless a person with OCD is severe and has received at least 2 trials of SSRIs and of CBT.Antipsychyotics were recommended by NICE because other published trials showed some minor benefit in OCD. However I recommend Ben Goldacre’s book on Bad Pharma to understand the impact of negative trials and other problems with the pharmaceutical industry.Whilst discussing antipsychotics, it’s worth mentioning a recent paper by Thus for all these reasons I don’t personally like to recommend antipsychotics even in severe treatment refractory OCD because the possible benefits are minimal and side-effects can be a significant problem. EX/RP was also superior to risperidone at improving insight, functioning, and overall quality of life. It is a sad fact that many people with OCD delay seeking help. Others become obsessed with the idea that they will be responsible for a catastrophe and feel driven to compulsively check that the stove is turned off and the door is locked. Registered charity No: 1154202. Interaction of risperidone with the dopamine D1 receptor only occurs at very high concentrations. Individuals randomized to receive risperidone met with a study psychiatrist weekly for the first four weeks of the treatment, and biweekly thereafter. A SSRI is recommended if a person does not want CBT or something to be added to CBT if a person is not making sufficient progress. You don't have to feel worry, doubt or helplessness, What we don’t know is whether there are unpublished trials of antipsychotics, which have negative findings – it’s probably unlikely that there are unpublished trials in OCD for antipsychotics as they are not licensed for OCD and are a very small market compared to their use in schizophrenia. Our research group is currently conducting trials of several novel therapeutic agents.The study presented here was published online in JAMA Psychiatry on September 11, 2013 and was funded by the National Institute of Mental Health (grants MH045436 and MH45404). These individuals were randomized to receive eight weeks of EX/RP, risperidone, or pill placebo while their SRI medications were continued at a stable dose. OCD symptoms were rated before and after treatment using the "gold standard" OCD measure, the Yale-Brown Obsessive Compulsive Scale (YBOCS).After eight weeks of treatment, 80 percent of patients receiving EX/RP experienced symptom improvement (defined as at least a 25 percent reduction in symptoms). So off he went to the “local therapist,” the clinical psychologist in town whom all the teens liked.