In OCD, Add-On Cognitive Behavior Tx Beats Risperidone
(HealthDay News) – For patients with obsessive-compulsive disorder (OCD), the addition of cognitive behavioral therapy (exposure and ritual prevention [EX/RP]) to a serotonin reuptake inhibitor (SRI) is superior to risperidone or pill placebo, according to a study published online Sept. 11 in JAMA Psychiatry.
Helen Blair Simpson, MD, PhD, from Columbia University in New York City, and colleagues compared the effects of two SRI augmentation strategies vs. pill placebo in a cohort of patients with OCD. One hundred participants with OCD of at least moderate severity despite a therapeutic SRI dose for ≥12 weeks were randomized to receive risperidone (40 patients), EX/RP (40 patients), or placebo (20 patients). Eighty-six participants completed the trial.
The researchers found that the reduction in the week-eight Yale-Brown Obsessive Compulsive Scale scores was significantly greater for patients randomized to EX/RP vs. risperidone and placebo, with no significant difference for patients randomized to risperidone vs. placebo. There were significantly more responders among patients receiving EX/RP vs. risperidone and placebo. Minimal symptoms were achieved by significantly more patients receiving EX/RP vs. risperidone and placebo. Compared with risperidone and placebo, EX/RP was superior for improving insight, functioning, and quality of life.
"Patients with OCD receiving SRIs who continue to have clinically significant symptoms should be offered EX/RP before antipsychotics given its superior efficacy and less negative adverse effect profile," the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical technology industries.