Dr. Casey Halpern

So they have failed medication and there are multiple medications that are worth trying for OCD.

Some can actually be very helpful.

Well, SSRIs are sort of the first line for OCD, but also tricyclics can be helpful.

So this is still the serotonin system.

But as we know, the serotonin system interacts with the neurodegenerative system and the dopamine system.

So it's hard to...

be specific to one of these things.

And I think that's also why it's hard for us to predict how these medications are going to work for these kinds of patients.

But tricyclics and SSRIs can be very helpful and are definitely first line.

And there's others.

Exposure response prevention is probably the most effective option, which is kind of like cognitive behavioral therapy, but these are different and offered by psychologists.

And this is a whole field and there's a whole clinic at my institution

focused, it was started by Edna Foa at Penn who, this is what they do for these patients, is offer these types of cognitive therapies, exposure to the stressor and to try to get patients to habituate to whatever it is that stresses them and causes these compulsions to help these patients live in every day and function.

These are all,

fabulously helpful therapies for a variety of patients, but there's still about 30% of patients that still suffer from OCD.

And some of them have severe OCD, sometimes it's moderate to severe.

And those are the patients that I'm really motivated to try to help.

Our therapies for those patients right now, I would say are worth pursuing, but not optimal.

And so it's one of those things that we have to balance as a researcher, because when you see patients like this,

you wanna do everything you can to help them.