OCD: When to Discontinue Treatment?

Let’s begin by answering this question first:

Welcome to your OCD Duration

Q: Patient with diagnosis of obsessive compulsive disorder is stable on Fluvoxamine and CBT treatment. Y-BOCS also confirmed that patient is in remission. Patient is asking you if he can discontinue or lower the dose of Fluvoxamine. How long should a successful medication treatment for OCD be continued for before considering a gradual taper?

APA 2007 guideline recommends that successful medication treatment for OCD be continued for 1–2 years before considering a gradual taper.

Study Supporting Continuation of Active Treatment:

  • Meta-analysis compared data from five double-blind discontinuation studies.
  • Relapse occurred in 22.7% of subjects on active treatment versus 41.6% placebo group.

Risk of Discontinuation at <12 months:

  • Study found that discontinuing successful augmentation after 1–12 months resulted in relapse for more than 80% (15/18) of patients.
  • Most within 2 months of discontinuation.

REFERENCES:

  1. American Psychiatric Association. Practice guidelines for the treatment of patients with the obsessive compulsive disorder. Arlington, VA: American Psychiatric Association, 2007.
  2. J Affect Disord. 2010 Jun;123(1-3):9-16.
  3. Int Clin Psychopharmacol 2003; 18:23–28.

INTERESTED IN LEARNING MORE?

JOIN OBSESSIVE COMPULSIVE & RELATED DISORDERS UPDATE 2021 CONFERENCE:

ON 30% DISCOUNT TILL MAY 31

Conference Enrollment Closing on June 1, 2022

(Why? Because 5.25 CME Credits Expiring on June 23, 2022)

This educational conference was released in 2021 with 5.25 AMA PRA Category 1 CME credits (see below for more details). The CME credits are expiring on June 23, 2022, and the conference will close for enrollment on June 1, 2022.

This will be your last chance to enroll at a 30% discount (before June 1, 2022) and claim 5.25 CME credits (before June 23, 2021).

—> If you have already enrolled in the conference, please claim your CME credits now and email me if having any issues in claiming the CME credits.

CME ACCREDITATIONS

5.25 AMA PRA Category 1 Credits Available

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of PeerPoint Medical Education Institute and the Psychiatry Education Forum, LLC. PeerPoint Medical Education Institute is accredited by the ACCME to provide continuing medical education for physicians. PeerPoint Medical Education Institute designates the Enduring Material format for this educational activity for a maximum 5.25 AMA PRA Category 1 Credits™.

Physicians should only claim credit commensurate with the extent of their participation in the activity.

NOTE: CME Credits not available for the following two non-academic program presentations:

  1. Post-Partum Onset Obsessive-Compulsive Disorder: by Dr. Mary Kimmel.
  2. Deep TMS for Treatment-Resistant OCD: by Dr. Aron Tendler.

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