Refractory Obsessive-Compulsive Disorder: State-of-the-Art Treatment

Nonresponse to treatment in obsessive-compulsive disorder is common, associated with substantialimpairment, and understudied. Little practical advice is available to clinicians on next-step treatmentstrategies for patients who have not responded well to 2 trials of selective serotonin reuptake inhibitors(SSRIs). Available options include continuation of SSRI treatment, switching to another SSRI or selectiveserotonin-norepinephrine reuptake inhibitor, augmenting with atypical neuroleptics or cognitivebehavioraltherapy, or utilizing novel treatment approaches. The authors synthesize state-of-the-art treatmentand give practical advice for clinicians.’ ‹