Psychiatria pre prax 2/2018
Nové trendy v léčbě obsedantně kompulzivní poruchy
The aim of this paper is to summarize current treatments of obsessive-compulsive disorder (OCD) and to describe novel therapeutical strategies in the fields of pharmacotherapy, psychotherapy, stimulation, and neurosurgery. The use of SSRI antidepressants has a well documented efficacy and growing evidence supports augmentation of SSRI with atypical antipsychotics. A promising but not yet established field is represented by glutaminergic modulators. Cognitive behavioral psychotherapy (CBT) is the most effective psychotherapy and evidence supports also the use of remote CBT – computer-based and on-line CBT. Acceptance Commitment Therapy introduces a promising approach in the field of psychotherapy. More attention is focused on the role of the family in the treatment of OCD symptoms. Other treatment modalities are represented by stimulation methods – rTMS and tDCS. Neurosurgery with ablative procedures or deep brain stimulation provides an alternative for treatment refractory patients.
Keywords: obsessive-compulsive disorder, SSRI, augmentation, glutamate, cognitive-behavioral therapy, stimulation, neurosurgery
