OCD is a chronic illness that usually can be treated in an outpatient setting. The mainstays of treatment of OCD include the use of serotoninergic antidepressant medications, particular forms of behavior therapy (exposure and response prevention and some forms of CBT), education and family interventions, and, in extremely refractory cases, neurosurgery.
Patients who have achieved remission of symptoms with behavior therapy alone may never require medication and may instead need only to return to therapy if they have an exacerbation of their illness. Also, a subset of patients has been treated with a combined approach; these patients can discontinue medication, maintaining a remission with behavioral interventions alone
For OCD, selective serotonin reuptake inhibitors (SSRIs), cognitive-behavioral therapy, or a combination of the two are the main first-line treatment strategies
However, there are still about 60% of OCD patients who do not get satisfactory results after taking SSRIs
In empirical medicine, what adjuvant therapies may help obsessive-compulsive disorder? See the text analysis for details
What is obsessive-compulsive disorder?
Obsessive-compulsive disorder (obsessive-compulsive disorder) is a heterogeneous mental illness with multiple subtypes and multiple manifestations. The lifetime prevalence rate is 1% to 3%. There are several related diseases (usually called obsessive-compulsive disorder). Spectrum disorders), such as body deformity, trichotillomania, hypochondriasis and eating disorders.
The characteristics of the disease include obsessive thoughts, compulsive behaviors, or both, and can cause severe personal distress or social disorders.
Obsessive thinking refers to repeated and persistent thoughts, images or impulses that can cause obvious anxiety and pain. Patients will realize that these thoughts are self-generated and are inappropriate.
Compulsive behavior is a repetitive activity or spiritual ritual designed to counteract the anxiety caused by compulsive thinking. Common compulsions include washing hands, checking, ordering, praying, counting numbers, and seeking peace of mind
If not treated in time, obsessive-compulsive disorder will usually recur and become a chronic disease, which will seriously damage the quality of life and restrict social and professional life
What are the complementary therapies that help obsessive-compulsive disorder?
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N-acetylcysteine
Acetylcysteine is an acetylated variant of the amino acid L-cysteine. It is an excellent source of sulfhydryl and is converted into metabolism that can stimulate glutathione synthesis in the body. It can promote detoxification and directly act as a free radical scavenger.
Acetylcysteine has been used as a mucolytic (phlegm-reducing agent) for many respiratory diseases, and under conditions of reduced glutathione or oxidative stress, such as HIV infection, cancer, heart disease and Smoking, it seems to have a beneficial effect.
A systematic review (including 5 randomized placebo-controlled trials related to obsessive-compulsive disorder, 3 case reports and 2 case series) pointed out that N-acetylcysteine (N-acetylcysteine) add-on therapy improves the condition Can bring positive effects. Note 1
＊Conclusion: Acetylcysteine adjuvant therapy may have a positive effect on the improvement of obsessive-compulsive disorder, but it is limited by the low quality and heterogeneity of the existing evidence, and more studies are needed for further verification
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Indian Ginseng (Ashwagandha)
Indian ginseng, also known as Ashwagandha or Ashwagandha, is a kind of medicinal herb. It has the properties of adaptogens and is believed to have a wide range of pharmacological effects, including: anti-anxiety, lowering blood pressure, sedation, immune regulation, Anti-inflammatory, anti-tumor, and antioxidant effects
The term adaptogen refers to when the body is disturbed by stress, it can regulate metabolism, help the body adapt to normal system functions, develop resistance to stress, and improve body functions to a higher level
A double-blind controlled study (a 6-week period of 30 obsessive-compulsive patients treated with SSRIs) pointed out that compared with drug treatment alone, Indian ginseng combined with drugs can further improve the scores of the OCD scale (Yale-Brown Obsessive -Compulsive Scale), may be an option for complementary therapy. Note 2
The underlying mechanism is related to Indian ginseng’s ability to enhance serotonin synthesis and regulate synaptic receptors.
＊Conclusion: Indian ginseng combined with conventional therapies may improve the treatment effect of obsessive-compulsive disorder, but it is limited by the scale of small studies and still needs further confirmation by large studies
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Valeriana (Valeriana officinalis)
Valerian is a plant native to different temperate regions of America, Europe and Asia. Its rhizome contains several compounds, including essential oils and sesquiterpenoids (valerenic acid), epoxy iridoids, Amino acids (arginine, gamma aminobutyric acid, glutamic acid, tyrosine) and alkaloids
In traditional medicine, valerian has various therapeutic effects such as hypnosis, sedation, anti-anxiety, anti-convulsant and anti-depressant.
A double-blind randomized controlled trial (8 weeks for 31 patients with obsessive-compulsive disorder) pointed out that compared with placebo, oral valerian root extract (daily dose 765 mg) can improve the symptoms of obsessive-compulsive disorder (yale-Brown obsessive-compulsive disorder) Scale measurement (Yale-Brown. Obsessive Compulsive Scale, Y-BOCS)). Note 3
The underlying mechanism may be related to the regulation of valerian on GABAA receptors
＊Conclusion: Valerian root extract may have a positive effect on the improvement of obsessive-compulsive disorder, but due to the small number of samples, more studies are needed to confirm its clinical benefits
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Aerobic exercise
Lack of exercise is a universal problem worldwide. About two-thirds of adults do not meet the minimum recommended amount of exercise, and 68% of American adults are classified as overweight or obese
Moderate aerobic exercise has many benefits. Studies have found that regular aerobic exercise can bring physiology and physiology benefits. For example, it can reduce the risk of cardiovascular disease, metabolic disease, depression, and bone and joint diseases
In a randomized controlled trial (12 weeks, 55 patients with refractory obsessive-compulsive disorder), the control group was given a static health education course, and the treatment group was given aerobic training. Note 4
It was found that aerobic training exercises greatly increased positive emotions and reduced anxiety and compulsive behaviors
＊Conclusion: Aerobic exercise may bring positive help to the improvement of obsessive-compulsive disorder, but due to the small sample size, more research is needed for further verification