OCD Treatment Using Augmentation Therapy to Treat OCD By Owen Kelly, PhD Owen Kelly, PhD, is a clinical psychologist, professor, and author in Ontario, ON, who specializes in anxiety and mood disorders. Learn about our editorial process Owen Kelly, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on December 22, 2020 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Review Board Steven Gans, MD Updated on December 22, 2020 Print Jose A. Bernat Bacete / Getty Images Augmentation strategies involve using combinations of drugs, rather than a single OCD medication. Augmentation therapy involves using combinations of drug, rather than a single OCD medication, for maximum effect. Augmentation strategies could be especially effective for people who do not respond to standard OCD medication. Why Augmentation Is Used If you have OCD, you may know that a variety of treatments are available. However, you may also know that not all people respond to these treatments. Although the introduction of selective serotonin reuptake inhibitors (SSRIs), such as Luvox (fluvoxamine), Prozac (fluoxetine), Paxil (paroxetine) and Zoloft (sertraline), and tricyclic antidepressants, such as Anafranil (clomipramine) have been a huge step forward in the treatment of OCD, 40 percent to 60 percent of people will not respond adequately to these drugs. As in other areas of medicine, psychiatrists are now exploring whether treatment of OCD with a combination of medications, rather than a single medication, offers more relief for more people. Using Antipsychotic Medications to Augment Current Treatments Although antidepressants are the standard medical treatment for OCD, it has been suggested that adding antipsychotic drugs to a treatment plan could be helpful in improving OCD symptoms. Why is this? First, antipsychotic medications such as Risperdal (risperidone), Zyprexa (olanzapine) or Seroquel (quetiapine) affect levels of the neurotransmitter dopamine in addition to influencing serotonin. Problems with the dopamine system have also been implicated in OCD. In addition, some people with OCD may have difficulty believing that their obsessions and/or compulsions are illogical or unreasonable. A failure to recognize that obsessions and/or compulsions do not make sense has been shown to be a barrier to benefiting from standard treatments. It has been suggested that antipsychotic medications may be effective in helping change this pattern of thinking. Does Augmentation Therapy Work? In general, the available scientific evidence suggests the use of antipsychotic medications may be useful augmentation drugs for adults whose OCD symptoms have not responded to standard treatments, however further research is warranted. However, you must keep in mind that there are two categories of antipsychotic medications, each with their own potential side effects. The first generation or "typical" antipsychotics tend to have side effects related to abnormal movements, referred to as extrapyramidal side effects such as rigidity, tremors, slowness, restlessness and tardive dyskinesia, which involves the involuntary and uncontrollable movement of different parts of the body including the mouth and face. Tardive dyskinesia can sometimes be permanent. The second-generation or "atypical" antipsychotics usually have less risk of extrapyramidal side effects but are more likely to cause metabolic problems such as weight gain and elevated blood sugars and cholesterol. Given this, the potential benefits of using an antipsychotic medication as an augmentation strategy for reducing OCD symptoms should outweigh the risks. As with any medical treatment, the decision to add an antipsychotic medication to your current treatment plan is a choice that should be made in strong collaboration with your family doctor or psychiatrist. OCD Discussion Guide Get our printable guide to help you ask the right questions at your next doctor's appointment. Download PDF Be sure to communicate any changes you experience when trying a new medication or when switching medications, too. Keeping this open line of discussion between you and your doctor will ensure that he/she is keeping your individualized needs in mind when progressing in your treatment plan. OCD and Your Relationships Was this page helpful? Thanks for your feedback! Learn the best ways to manage stress and negativity in your life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Bloch MH, Landeros-weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry. 2006;11(7):622-32. doi: 10.1038/sj.mp.4001823 Skapinakis P, Papatheodorou T, Mavreas V. Antipsychotic augmentation of serotonergic antidepressants in treatment-resistant obsessive-compulsive disorder: a meta-analysis of the randomized controlled trials. Eur Neuropsychopharmacol. 2007;17(2):79-93. doi:10.1016/j.euroneuro.2006.07.002 Obsessive-compulsive disorder. National Institute of Mental Health. Published online, updated October 2019. Additional Reading Bloch, M.H., Landeros-Weisenberger, A., Kelmendi, B., Coric, V., Bracken, M.B., & Leckman, J.F. “A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder” Molecular Psychiatry 2006 11: 622-632. Skapinakis, P., Papatheodorou T., & Mavreas, V. “Antipsychotic augmentation of serotonergic antidepressants in treatment-resistant obsessive-compulsive disorder: A meta-analysis of the randomized controlled trials” European Neuropsychopharmacology 2007 17: 79-93.