CBT and Psychopharmacology for OCD

Peggy Richter, MD

  • Associate Scientist, Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute
  • Head, Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre 
  • Director, Clinic for OCD & Related Disorders, Sunnybrook Health Sciences Centre
  • Affiliate scientist, Neurosciences Department, Centre for Addiction and Mental Health
  • Associate Professor, department of psychiatry, University of Toronto
  • Associate Member, graduate faculty, Institute of Medical Science, University of Toronto

Dr. Richter describes how CBT and various medication options can help treat people with OCD.

Tapering OCD Pharmacotherapy Support (TOPS) Study

Eligibility Criteria

Adults with OCD who wish to stop taking long-term (2 years or more) SRI medication may be eligible to participate. 

State
Rhode Island

The aim of the TOPS Study is evaluate the discontinuation of long-term serotonin reuptake inhibitors (SRIs) in individuals with obsessive-compulsive disorder (OCD).  

Participation in TOPS involves an initial screening appointment to ensure eligibility that includes completion of interviews and questionnaires. 

Eligible individuals are then randomly assigned to one of two 22-week programs using different techniques to help people come off medication.

All study participants will receive

Extending Ketamine's Effects in OCD With Exposure and Response Prevention (ERP)

Eligibility Criteria
  • Ages 18 to 55
  • Physically healthy and not currently pregnant
  • Primary diagnosis of OCD
  • Sufficient severity of symptoms
  • Currently off all psychotropic medication OR Currently on adequate dose of medication for treatment of OCD, but have not achieved at least partial remission and are eligible for a medication washout
  • Able to provide consent
Exclusion Criteria
  • Psychiatric conditions that make participation unsafe (schizophrenia [either self or first-degree relative, e.g. siblings, parents], history of violence, severe depression, eating disorder, substance dependence [including nicotine])
  • Female patients who are either pregnant or nursing
  • Planning to commence EX/RP during the period of the study or those who have completed an adequate dose of EX/RP (defined as 8 or more sessions within 2 months) within 8 weeks prior to enrollment
  • Allergy to ketamine
  • Participants for whom being off of medication is not clinically recommended
  • Medical conditions that make participation unsafe (e.g. high blood pressure, head injury)
  • Currently on medications that make participation unsafe
State
New York

This study investigates whether a single dose of IV ketamine can rapidly improve OCD symptoms and the effect can be maintained with exposure and response prevention (EX/RP), a condensed course of a type of cognitive-behavioral therapy.

You will be compensated for your time and travel.

Randomized Controlled Trial of Intranasal Ketamine vs. Intranasal Midazolam in Individuals With OCD

Eligibility Criteria
  • Ages 18 to 55
  • Physically healthy and not currently pregnant
  • Primary diagnosis of OCD
  • Sufficient severity of symptoms
  • Currently off all psychotropic medication OR Currently on adequate dose of medication for treatment of OCD, but have not achieved at least partial remission and are eligible for a medication washout
  • Able to provide consent
Exclusion Criteria
  • Psychiatric conditions that make participation unsafe (schizophrenia [either self or first-degree relative, e.g. siblings, parents], history of violence, severe depression, eating disorder, substance dependence [including nicotine])
  • Female patients who are either pregnant or nursing
  • Planning to commence EX/RP during the period of the study or those who have completed an adequate dose of EX/RP (defined as 8 or more sessions within 2 months) within 8 weeks prior to enrollment.
  • Allergy to ketamine
  • Participants for whom being off of medication is not clinically recommended
  • Medical conditions that make participation unsafe (e.g. high blood pressure, head injury)
  • Currently on medications that make participation unsafe
State
New York

This study will test if intranasal ketamine is feasible to use and can reduce OCD symptoms significantly more than a comparison medication called midazolam. Therefore you may or may not receive ketamine as part of this study. Results from this study will allow doctors and researchers to better understand if you and others with OCD may respond to this class of medications.

You will be compensated for your time and travel.

Randomized Controlled Trial of GLYX-13 in Individuals With OCD

Eligibility Criteria
  • Ages 18 to 55
  • Physically healthy and not currently pregnant
  • Primary diagnosis of OCD
  • Sufficient severity of symptoms
  • Currently off all psychotropic medication and other drugs OR Currently on adequate dose of medication for treatment of OCD, but have not achieved at least partial remission and eligible for a medication washout 
  • Able to provide consent
Exclusion Criteria
  • Psychiatric conditions that make participation unsafe (schizophrenia [either self or first-degree relative, e.g. siblings, parents], history of violence, severe depression, eating disorder, substance dependence [including nicotine])
  • Female patients who are either pregnant or nursing
  • Planning to commence EX/RP during the period of the study or those who have completed an adequate dose of EX/RP (defined as 8 or more sessions within 2 months) within 8 weeks prior to enrollment
  • Allergy to ketamine
  • Participants for whom being off of medication is not clinically recommended
  • Medical conditions that make participation unsafe (e.g. high blood pressure, head injury)
  • Currently on medications that make participation unsafe
State
New York

This research study tests whether GLYX-13 — an experimental drug that acts on a brain receptor called NMDA — can decrease symptoms of OCD within hours. This is not a treatment study. Results from this study will allow doctors and researchers to better understand if you and others with OCD may respond to a class of medications that target the NMDA brain receptor.
You will be compensated for your time and travel.

 

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