OCD Treatment Study: For those Taking Medication but Still Having Symptoms in Philadelphia and New York

This is a study for people who are taking medication for Obsessive Compsulvise Disorder (OCD) but still have trouble with OCD symptoms. The study provides a type of Cognitive Behavioral Therapy for OCD to see whether this therapy can help people become well and then stop taking their medication.

Medication and OCD

The most commonly used treatment for obsessive compulsive disorder (OCD) is a group of medications called serotonin reuptake inhibitors (SRIs). Despite research showing that these medications help many OCD patients, a substantial number who take such medications remain symptomatic. In fact, on average patients taking SRIs experience only a 30% reduction in their OCD symptoms and most have side effects that impact their quality of life.

Another Treatment Option

Another treatment for OCD is a type of cognitive-behavioral therapy called Exposure and Response Prevention (EX/RP). EX/RP has been found effective as a stand-alone treatment for OCD and it can also further reduce OCD symptoms in patients who take medication and continue to experience OCD related distress. Not only is EX/RP effective in reducing symptoms, many patients are able to maintain their gains after therapy has stopped.

Our OCD Treatment Study

The goal of this study is to identify who benefits from adding Exposure and Response Prevention to SRI medication and to find out whether they can discontinue their SRI. Participants in the study will receive up to 25 twice-weekly sessions of EX/RP. Participants who experience a significant reduction of OCD symptoms from EX/RP will be randomly selected to either: 1) gradually discontinue their medication and begin taking a placebo (sugar) pill instead or, 2) to continue taking their medication. Participants will not know if they are taking placebo or medication. All participants will be monitored by the study psychiatrist for an additional 6 months and will receive monthly therapy sessions to help them maintain the gains made from EX/RP.

This study is being conducted in Philadelphia at the University of Pennsylvania and inNew York at Columbia University. To participate in this research, you must be able and willing to travel to either Philadelphia or New York for all study visits.

Click here to find out more about eligibility for our OCD treatment study.

Warning:People with OCD should never try to stop taking their medication without supervision by their prescribing doctor.

Center for the Treatment
and Study of Anxiety
University of Pennsylvania
3535 Market St, 6th Floor
Philadelphia, PA 19104
215-746-3327

EDITED 12/18/14
The contact info for the New York Site has changed:  (646) 774-8062 and the new email is mschwar@nyspi.columbia.edu

Participants Wanted for Mt. Sinai Hospital on Learning How Cognition Works in OCD

Behavioral and fMRI studies of cognition in healthy individuals and patients with anxiety

ID Number 11-1344

Principal Investigator(s) 
Emily Stern 

Department(s) or Division(s) 
Psychiatry 

Description 

The current research study is designed to learn more about how cognition works in individuals with anxiety disorders, specifically Obsessive-Compulsive Disorder (OCD).  This study uses neuroimaging techniques (fMRI) to examine the neural mechanisms underlying switching attention in individuals with a diagnosis of OCD.  

Potential participants may qualify to take part in this research study if they are between the ages of 18 and 50 without a history of serious problems with their health (such as a heart attack), emotions (such as depression) or nervous system (such as seizures), have received a diagnosis of Obsessive-Compulsive Disorder, and are interested in participating in psychological research.

Contact Information 
Alexandra Muratore
(212) 824-8995
sinaibrainlab@mssm.edu 

Recruiting Patients: Yes 

Link http://icahn.mssm.edu/research/clinical-trials/11-1344

Dealing with OCD Health Anxiety and Preventive Screenings

I had a week in January with my annual screening mammogram, followed by my diagnostic colonoscopy for chronic anemia. I am proud of myself for getting through it all in spite of anxiety.

The mammogram center had moved to a new office and actually had a radiologist there to read the results while I waited, and the results were normal. My mind did its usual "what ifs" but I did feel a flash of relief.

The colonoscopy prep was not how I would like to spend a day, but it also wasn't awful, and it is encouraging that I can deal with something uncomfortable. There was a small benign polyp but not the cause of my anemia. I am in that borderland of being old enough that the gastroenterologist wanted to "make sure" even as he reassured me that nothing was probably wrong at the initial consult in November.

Medical screening and testing stirs up my health anxiety, and I am learning to accept that, and keep going. I did not do any web research. I did see my therapist when my anxiety was high in September, as I wrote about in a previous post. I am learning to expect the surge in anxiety and not launch int ruminating about why it is back, why the OCD anxiety shows up. This defuses my panic, and my "oh no!" response.

Pharmacological Treatment of OCD: DVD's Available of Dr. Steven Poskar's Presentation at OCDNJ

I subscribe to the newsletter of OCD New Jersey and recently they had a Dr. Steven Poskar of OCDNY as their guest speaker.

Dr. Allen Weg, VP of OCDNJ, sent out this note after the presentation about DVD's, and I thought I would pass it on, because it sounds like a useful resource: 

. . . if you were not at our meeting last night (and, actually, even if you were), and you are interested in the latest in medication options for OCD, you should consider ordering a DVD of Dr. Steven Poskar's presentation.  It was an incredibly thorough and exhaustive review of what is out there, including some of the newest avenues of research.  If interested, call OCDNJ President Ina Spero at 732-828-0099. 

Dr. Steven Poskar is a certified Diplomate in Psychiatry by the American Board of Psychiatry and Neurology. He specializes in psychopharmacology and cognitive behavioral therapy at the Spectrum Neuroscience and Treatment Institute in New York City.

Dr. Poskar is a co-founder and current Vice President of OCDNY, the NY affiliate of International OCD Foundation. He is a member of the International OCD Foundation’s Body Dysmorphic Disorder, Hoarding and Autism Spectrum Disorder Special Interest Group.

Dr., Poskar’s presentation is entitled, “Pharmacological Treatment of OCD: The very latest developments in exploring options.” This presentation is an exhaustive review of the many medication options now available for those struggling with OCD and those treating them, including the very latest information on approaching the psychopharmacological treatment of OCD, not only by targeting serotonin and dopamine sites, but glutamate abnormalities as well.

Living With Me and My OCD: Check out the Trailer for Claire Watkinson's Documentary

In the summer, I recorded my story about having OCD for Claire Watkinson's documentary film Living with Me and My OCD.  I'm sharing the trailer here and Claire's introduction to the project, which is set for release in 2013.  I am excited that she has taken on this project to share stories of living with OCD.

My name is Claire Watkinson, I am a freelance filmmaker and a sufferer of OCD. Living With Me And My OCD is a personal documentary about OCD that I started filming in January. The feature is set for release in 2013. It will include interviews with sufferers of OCD, diary entries from myself, the Bupa Race, OCD UK and many more exciting organisations.

I am so happy by the amount of support and comments this documentary has recieved. I am touched and means so much. Please join this campaign. I need more interviews, people and interest. Get in touch, share this page and lets get OCD more talked about!

Claire Watkinson's Twitter for Living With Me and My OCD

Buy Living with Me and My OCD Wristbands

Check out the trailer:

Fear of Being a Bad Patient: Health Anxiety and Self-Worth

Problem for me is I also have social anxiety. Dealing with doctors is just as anxiety provoking as worrying about illness. My symptoms and test results seem just worrying enough to warrant monitoring the situation but I'm constantly worried the doctor will think I'm just being a hypochondriac.

I actually looked through some books on hypocondria, but they all focused on worrying about something that has been ruled out. Which isn't the case for me. I'm working on establishing a format of when to call a doctor, which symptoms or tests should be followed up on and which need not. I'm finding this helps me to let it all go and enjoy things more, particularly when I am having low symptom period. I've got a ways to go, though. :)

I've been thinking about this comment by MinM on my post Hypochondria and Health Anxiety OCD.  The social anxiety of dealing with doctors complicates my health anxiety, as well as cultural stereotypes of women as oversensitive, and my perfectionism which demands I pre-diagnose myself and get it right before I even go to the doctor.

I spent many years at my old job listening to medical residents do their rounds, and anything to do with the mind and emotions and human complications was a struggle for them in the midst of all the technical, diagnostic work they were doing.  There was a staff psychologist who would sit in at times, and I was glad to have her there providing some perspective.  Also, some residents were much more able to deal with anxious patients than others.

OCD is still an enigma to many people, professional or not, and health fears are often labeled hypochondria, even though health anxiety OCD has a significant component of dealing with uncertainty and rituals to try and undo the fear, such as repeated calls to doctors, web searching symptoms and monitoring and checking body symptoms in a similar way to those who check locks, stove burners and light switches.

My latest challenge was a physical in October with my family doctor, who was concerned about my low iron levels and said since I was "close enough to 50" that she was going to refer me for a colonoscopy.  Getting older adds another layer to health anxiety.  I'm still a few years away from 50 and I felt a surge of panic that I was going to choose the wrong thing, do the wrong thing.

Ironically, my doctor was not "certain" about this.  She even went and talked to a colleague to see if she sounded "crazy."  Here was her thought process: My iron levels could be due to being female, but she's seen too many cases of patients in their 40's who turned out to have colon cancer, and while she doubts that there is something seriously wrong with me, she wanted to play it safe, and have me consult with a gastroenterologist.

Does this sound omnipotent or certain?  No.  Do I deal well with uncertainty?  Well. . .I hadn't seen Leonard, my exposure therapist, in 5 months, so I made an appointment to sort this out with him.  I didn't look up colonoscopies in the meantime, which is huge for me.  Leonard made me laugh by saying the sedative is fabulous with a colonoscopy. . .he'd also heard that the guidelines might be changed to start a screening colonoscopy at 40 rather than 50.  

For him, it didn't trigger a big emergency because his self-worth was not at stake, as opposed to my perfectionism, which decreed I'd better get this right or prove my defectiveness.  Leonard asked if I really believed that there is a way for someone to prove I'm defective as a person by looking at my colon.  I made the appointment with the gastroenterologist and saw him a couple weeks ago.  He basically said the same thing as my family doctor, about wanting to err on the side of caution.  I scheduled the colonoscopy for January.  

If you are a reader tempted to write me a treatise about the dangers of overtesting, and other sociological factors about suburban US medicine, please be assured I've already thought about all of this, and I've taken my best guess.  Does this scare me?  Yes, it does, because I'd prefer to make a perfect omniscient choice, but ritualizing to give myself the illusion of being able to make a perfect choice has stolen many years from me already.

Some of what I've learned over the years of dealing with my OCD with Exposure Therapy:

• It's important for me to trust and respect my doctors, and be able to honestly say when I'm struggling with the OCD.  The anxiety of figuring out how to indirectly get my questions answered was exhausting when dealing with doctors who had little patience for anxiety.

• Even people without OCD have a difficult time gauging when to go to the doctor.  There will be uncertainty.   I may be wrong.  This doesn't say anything about me as a person.

• Self-Monitoring and vigilance will not magically protect me from illness and disease, as evidenced in my experiences: Skin Cancer Anxiety: Fear, Vigilance and All or Nothing Thinking and Skin Checks and OCD: Never Enough.

Relationship OCD: Two Hard Things at Once

The post on Exposing OCD with the most comments and reader resonance is Relationship OCD and Fear of Choosing the Wrong Person or Gender.  I wrote it over 2 years ago, and it still gets comments.  There is a thread of pain throughout the comments, which I find sobering.  

I am not a professional.  I am not a therapist.  I am someone sharing my story and my experience.  If there's any lesson, it's not that my readers need to marry the one they are with, or not marry the one they are with, or find another gender, but that OCD latches onto what is important to us, such as love or connection, or a particular person, or imagined ideal person.  

Relationship struggles are hard enough without OCD, and there's nothing magical about OCD treatment that will make relationships struggle-free, but it can give you the chance to choose to live your life, and choose who you love.  

OCD is offering a false promise that you can banish all fears and doubts, all unwanted thoughts, all gnawing anxiety, if you just come up with the right ritual of analysis, research, checking, double checking, monitoring feelings or repeating certain phrases.  

When I married my husband 20 years ago, I could've made the wrong choice.  Many marriages end in divorce.  The brave part was making a choice, without having absolute omniscient knowledge of the future, which of course no human gets.   Getting married didn't make my OCD go away, but I did have the victory of choosing what I wanted(or rather, my best guess of what I wanted).    

Professional help and OCD support groups are about making an investment in your future, an investment in your life, in facing the disorder that barrages you with thoughts that go against the core of your being, and yet the more you wrestle with them, the more they cling.