Abstract
This chapter reviews the outcome literature on the efficacy of combined pharmacotherapy and cognitive-behavioral therapy (CBT) for obsessive compulsive disorder (OCD). By far, most research on combinations of CBT and pharmacotherapy for OCD has examined antidepressant medications, particularly those in the serotonin reuptake inhibitor (SRI) class. Quantitative review of randomized studies in which treatments were combined simultaneously indicated that combined therapy shows a small but significant advantage over exposure and response prevention (ERP) monotherapy, and a moderate advantage over pharmacologic (antidepressant) monotherapy. Studies of sequential treatment combination, in which CBT was added after a trial of antidepressant medication, suggest a significant incremental benefit of CBT, including for patients who show minimal response to antidepressant medication alone. The chapter concludes by discussing new pharmacologic possibilities for combined therapy, such as the use of D-cycloserine (DCS).
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