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First step is to talk about your symptoms with your doctor. Next OCD is going to treat with cognitive behavioral therapy, medication. Sometimes both will be done.
Cognitive behavioural therapy: Generally, it tells you about the obsessions and compulsions in the different ways of thinking, behaving and reacting. And the exposure and response prevention are a specific form of CBT. In this the patient is allowed to exposing the fears or obsessions and teaches you about the anxiety they cause and healthy ways and habit reversal training can help to overcome the compulsions.
Medication: Doctors can prescribe the different drugs to treatment of OCD like (SSRIs) or (SRI) called clomipramine. These are commonly used for depression, and symptoms of OCD. These SSRIs can take 10-12weeks to start working.  Suppose if depression extra longer time may take. (https://www.nimh.nih.gov/index.shtml) Medications like SRIs




The adrs are dry mouth, dizziness, fatigue, constipation, somnolence, and nausea. 

Because of risk of seizures the dose should not exceed 250mg. And cautions should be used (www.pubmed.com, Ciba-Geigy,1998)

Dose:  25mg/day (at bed time) and Increased in first 2weeks to 100mg and the maximum dose can have increased up to 250mg. (www.pubmed.com, Ciba-Geigy,1998)



The side effects are nausea, headache, anxiety, sedation, insomnia, tremor, sexual dysfunction. (Dista Products 40)

Dose: effective dose-20-80 mg/day

Initial dose: 20mg/day(mng)

Average: 40-60mg/day

Maximum: 80mg/kg. (Gary S. Sachs)

Doses greater then 20mg can be given twice daily (mng and noon). (Dista Products 40)



The adrs are insomnia, nausea, somnolence, abnormal ejaculation, dry mouth (Solvay Pharmaceuticals )

Dose: Initial - 50mg/day (bed time) this can be increased to 50mg for every 4-7 days.

Average: 200mg/day

Maximum: 300mg/day.

The manufacture recommended 100mg is given BD. At bed time.

The Children 8-17yrs dose is 25mg at bed time. And increased to 25mg for every 4-7days and maximum - 200mg/kg BD (Solvay Pharmaceuticals )



The adrs are insomnia, nausea, somnolence, sexual dysfunction, dry mouth

Dose: Initial: -20mg/day increased 10mg from after a week.

Average: 40-50 mg/day

Maximum:60mg/day (Beecham Pharmaceuticals )



The adrs are insomnia, nausea, dry mouth, dizziness, sexual dysfunction.

Dose: initial - 50mg/day it can have increased to 200mg/day OD (mng or eve). (Pfizer,2000)



The adrs are nausea, vomiting, and decreased sleep. Increased dreaming, organic dysfunction. (Koponen H,1997)

Dose:  20mg/day or 40mg/day or60mg/day. Most of the patients may took 40 or 60mg/day. (Montgomery S,2000 )

Initial: 20mg/day and increased 20mg in intervals after 1 week. And omeprazole can decrease the clearance of citalopram. (Forest laboratories )

Pregnancy and lactation: -
Generally, CBT is given alone to a pregnant patient except in risk of treating of OCD (Gary S .Sachs,1997) These symptoms may exacerbate in 1st trimester   and these symptoms may improve in 2nd and 3rd trimester.  (Diaz SF,1997 )
Drug used fluoxetine cannot increase the risk. (Gold stein,1995, Pastuszak,1993 ).it is the safest choice.

All SRIS are excreted into the breast milking lactation also fluoxetine is the safest drug. Several infants have been safety breast feed during maternal fluoxetine use. (Burch KJ,1992, Taddio A,1966)
There are 3main therapies
a) Medication therapy
b) Family therapy
c) Group therapy [www.helpguide.org]
Self-help for OCD:  
Don’t avoid your tears
Refocus your attention.

When you are having OCD thoughts then you can try to shift your attention to something else.

Challenge obsessive thoughts:
• Take a pencil and write your thoughts on the keypad, phone, or something else by writing it hundreds of times it will help you.
• Create an   OCD worry period: In this you can put some time like during this time you don’t think anyone or don’t anxious or don’t worry about anything and slowly continue to about the day.
• Create a tape of your OCD obsessions: you can record your obsessions or worries in the recorder and by listening that it comes to your mind. you can listen at least every 45min each day. By continuously doing this you will become less anxious and can repeat this to avoid.
• Take care of yourself
• Practice relaxation techniques. By doing mediation, yoga, deep breath or other techniques can help you to lower the stress and manage the tensions also. For best results it can do regularly.
• Get enough sleep: Insomnia occurs not only because of anxious and worry and also for lack of sleep. When you will take rest, it can must easier to keep your mind relax.
• Avoid alcohol and nicotine.
• Reach out for support
• Stay connected to family: By talking about your thoughts to your friends can feel less worries and urges and become less threatening.
• Join in OCD support groups: In this group there are so many members who are with the same symptoms they can discuss each other and come out by facing the problems. (www.helpguide.org)

Although there is no cure for OCD, and its exact origins are not specifically known by science or medicines at this time, there is help for those who suffer from compulsions obsessions, and severe or intense anxiety created by unwanted thoughts and inaccurate beliefs .The first step toward feeling better is to seek out the help of a therapist through a medical clinic, mental health facility or with the help of family members or friends.OCD anxiety and activities can be reduced through different types of management.

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