What is OCD?

SSRIs are effective for OCD yet there is little to no evidence of serotonin-system disruption in OCD, undercutting the standard chemical-imbalance explanation.

“There is very little, if any, evidence that the serotonin system is disrupted in OCD.”

CBT alone reduced Y-BOCS scores from 25 to roughly 11 within four weeks in OCD patients.

“Cognitive behavioral therapy had a dramatic effect in reducing the obsessions and compulsions such that by four weeks that score that in this case ranged from 8 to 28 dropped all the way from 25 down to about 11.”

Adding SSRIs to CBT produced no further reduction in OCD symptoms beyond CBT alone, contradicting the assumption that combination therapy is superior.

“The combination of cognitive behavioral therapy and the SSRIs together did not lead to any further decrease in OCD symptoms.”

Smoked cannabis (THC or CBD) has little acute impact on OCD symptoms and produces smaller anxiety reductions than placebo, running counter to popular perception of cannabis as an anxiolytic for OCD.

“Smoked cannabis whether containing primarily THC or CBD has little acute impact meaning immediate impact on OCD symptoms and yield smaller reductions in anxiety compared to placebo.”

TMS combined with D-cycloserine represents an emerging one-day outpatient protocol for anxiety and OCD with multi-month durability, worth monitoring as an accessible neurostimulation therapy.

“I've been able to get like a 90% reduction in my generalized anxiety disorder and OCD for 3 to four months at a time.”

A one-day TMS protocol augmented with D-cycloserine yielded a self-reported 90% reduction in generalized anxiety disorder and OCD lasting 3 to 4 months per treatment.

“I've been able to get like a 90% reduction in my generalized anxiety disorder and OCD for 3 to four months at a time.”

Transcranial magnetic stimulation (TMS) targeting motor and supplementary motor cortex can interrupt compulsive behaviors and reduce OCD symptoms, with early small-cohort evidence of effectiveness.

“We know that the TMS coil can interrupt the motor behaviors, the compulsive behaviors, and at least in a small cohort of studies and a small number of patients within those studies, this has been shown to be effective.”

Mindfulness meditation does not directly relieve OCD symptoms. Its benefit is indirect, working by sharpening focus so patients can engage more effectively with CBT.

“It's very unlikely, at least by my read of the data, to be a direct effect of meditation on relieving the symptoms.”