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CBT with exposure and response prevention (ERP)
ERP is a type of CBT and the main talking therapy for OCD. With a therapist, you gradually and safely face the thoughts and situations that trigger your anxiety, without doing your compulsions. Over time, the anxiety drops on its own and the urge to do compulsions weakens.
It can feel daunting, but you go at a pace you agree with your therapist. For milder OCD, this may be done with guided self-help or in a group. For more severe OCD, you may have more sessions.
Medicines
SSRI antidepressants, such as sertraline, fluoxetine, fluvoxamine or paroxetine, can reduce OCD symptoms. Higher doses than those used for depression are sometimes needed, and it can take up to 12 weeks to see the full effect. Keep taking them as prescribed and do not stop suddenly.
A medicine called clomipramine may be tried if SSRIs do not help.
Combined treatment
For moderate to severe OCD, NICE says a combination of CBT with ERP and an SSRI often works best.
Specialist services
If treatment has not helped, you may be referred to a specialist OCD service. There are also national specialist services for very severe OCD.
Next, read about living well with OCD.
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