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Flashcards in OCD Deck (14):
1

Dx Criteria for OCD

Obsessions and Compulsions >1h/day or cause impairment/distress
Pt must have insight into the fact it's excessive
Not explained by drug or other medical condition

2

Risk factors for OCD

Females
Childhood/adolescence - onset
Anxiety comorbidities
Family history

3

OCD Rating Scale

Y-BOCS
10 item quiz
Max - 40 severe

4

Adult Mild-Moderate OCD

CBT monotherapy
SSRI or clomipramine monotherapy

5

Adult Severe OCD

CBT AND SSRI or clomipramine

6

Adult First Line pharmacotherapy

SSRI > clomipramine
Equal efficacy and better side effect profile
Dose probably higher than p. insert max
Start slow (avoid rebound anxiety)
4-6 - good trial

7

Adult Second Line

Remeron or effexor
Switch SSRIs

8

Adult Successful Treatment

Lasts 1-2 years then reassess and try to taper

9

OCD and Pregnancy

CBT only
NO paxil/clomipramine

10

OCD and elderly

Start lower and go slower
NO paxil/clomipramine

11

Child Mild/Mod OCD

1st - CBT only
2nd - CBT + SSRI

12

Child Mod/Severe OCD

1st - SSRI + CBT
2nd - Augmentation

13

Med Considerations in Kids

Low and super slow
Can take up to 12 weeks (slower taper)
SUICIDE
6-12 months at dose then taper

14

Kid Failure Augmentation

Must have failed 2 SSRIs
SSRI + clomip (watch out with fluvox)
SSRI + risperidone