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Getting Help From a Psychiatrist for Your OCD? Research Shows That People Can Live Better Lives When ERP is Added to Medication.

By Dr. Jamie Feusner, MD

Nov 09, 20214 minute read

Reviewed byPatrick McGrath, PhD

You told us that you are getting help from a psychiatrist for your OCD. We are thrilled that you are showing up for yourself and are taking an essential step in managing OCD. However, it’s important to know that many people who take medication for their OCD enjoy better outcomes when exposure and response prevention therapy or ERP is added. 

Psychologists specifically created ERP to treat OCD. It works by gradually habituating people to see intrusive thoughts for what they are, accept uncertainty, and resist performing compulsions. 

Let’s touch upon medications’ role in treating OCD symptoms and then cover how people can use them in combination with ERP. 

Medication May Take Some Time to Work

If you’ve already had a consultation, your psychiatrist will have told you about the length of time it usually takes to see improvements with medication. It’s important to remember that the timelines I’m about to describe don’t start until you have reached a dose that works for you.

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If you haven’t had a consultation with a psychiatrist yet, it’s crucial to understand that for some people, it can take up to three months even to start experiencing a lessening of their OCD symptoms. Most people will begin to notice gradual symptom improvements after about 6-8 weeks, though occasionally, people experience a benefit as soon as two weeks into what we call a medication trial.

As you can imagine, this process may take a while, especially if your body is sensitive to side effects. A sensitivity could mean that you have to increase your dose very gradually or switch between different medicines to see which one best agrees with you. 

This systematic process can mean that it may take 6-12 months before settling on the medication strategy that reduces your symptoms without disrupting other aspects of your life.

Medications’ Effectiveness Depends On Consist Use

Your psychiatrist will also tell you that all medications used for OCD require consistency. While medications commonly prescribed to treat OCD differ in one way or another, whichever one you choose should be taken daily. You might miss a day now and then, but it’s best not to miss more than one day in a row or multiple days in a week. Pillboxes, phone reminders, and family members can be very supportive in helping to increase your success with taking medication consistently. 

Medications—along With ERP—are Considered “Gold-standard” Treatment for OCD   

While we’ve touched on the length of time it may take for medications to lessen your symptoms and the need for consistency, medication can make ERP possible for people with more extreme OCD. While drugs can effectively ease OCD symptoms, ERP is the tool you need to manage them long term. 

How does that relationship work? Well, medications can help reduce extreme levels of distress that might make it otherwise difficult to resist compulsions using ERP and lessen the severity of obsessions and compulsions. This combination gives them the best chance of seeing the long-term outcomes they are looking for. Those sought-after outcomes? Feeling better and getting their lives back.

With the addition of ERP, many people come to a point where the symptoms have no longer been bothersome for a long time, and they might be able to try to come off of the medications slowly. Doing ERP in combination with drugs, and continuing ERP after stopping medications, reduces the risk of symptom relapse. 

Many people do have a positive experience with medications. They may choose to take them for many years after initiation and perhaps even for the duration of their lives. Drugs can be highly beneficial, and in some cases necessary, for people who have been unable to undergo ERP. 

This inability may be due to other severe additional mental health disorders such as severe depression, severe panic attacks, or in general if the anxiety from exposures is too intense to tolerate ERP without the assistance of medication.

Research Shows the Effectiveness of Combining ERP with Medications

Like many treatments for mental health disorders (depression, anxiety, insomnia, bipolar disorders), the most effective treatment is combining therapy with medications. In the case of OCD, ERP is the gold standard therapy.

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Clinical guidelines state that adding treatment with ERP can lead to a better result for people who have an incomplete response to medications. 

By starting therapy with NOCD, you’ll not only be getting a jump on managing your OCD symptoms but also improving your long-term outcome. You’ll learn the tools to better manage your compulsions during the lengthy process of finding a medication that both works and doesn’t cause side effects. When you find a medication that works for you, you’ll have already learned so much about managing your OCD. When you combine these gold-standard treatments, you’ll have improved your chances of the best possible outcome.  

Learn more about the specifics of ERP and how to get started in treatment—with or without medication—here. 

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