Combining Pharmacotherapy and Exposure Plus Ritual Prevention for Obsessive Compulsive Disorder: Research Findings and Clinical Applications.

The efficacy of cognitive-behavioral therapy (CBT) involving exposure and ritual prevention (EX/RP) for obsessive compulsive disorder (OCD) has been well documented, as has the efficacy of pharmacotherapy using serotonin reuptake inhibitors (SRIs). Response to these monotherapies is neither universal nor complete, however, and in the past 20 years significant progress has been made in examining the efficacy of combined EX/RP plus SRI treatment. Results of randomized controlled trials that have employed adequate methodology suggest that combined treatment may afford some advantages over the monotherapies, although the effect is generally not robust and there are some negative findings. Combined treatment may be especially useful in certain clinical circumstances, however, and case examples are provided describing the use of combined treatment for one patient who presented with comorbid depression and for another who refused EX/RP because he perceived it as too threatening. [ABSTRACT FROM AUTHOR]