Obsessive-compulsive disorder (OCD) is a mental illness that affects almost 3% of Americans. It does not discriminate; it is said that several celebrities have come out to talk about their struggles with OCD from soccer legend David Beckham to superstar Justin Timberlake.

Several treatments have been studied for OCD with positive effects. Continue reading to learn more about OCD and what you can do to help yourself or a loved one who suffers from it.

What Is OCD?

OCD is a common and often chronic mental disorder that affects up to 2 to 3% of adults and up to 1% of children [1].

The OCD Cycle: Obsessions (repetitive thoughts) and compulsions (repetitive actions) characterize OCD. The disorder begins with an obsession that leads to anxiety, which then leads to compulsions to relieve this anxiety [2].

This image represents this repetitive loop:

The obsessions and compulsions can be unique to each individual. Four to five symptom clusters are common, and each has its associated compulsions [3]:

  • Symmetry obsession
  • Contamination and cleaning obsessions
  • Aggressive, sexual, and religious obsessions
  • Hoarding obsessions

Around 30 to 50% of individuals with OCD are often diagnosed before the age of 10. There may be a difference between childhood and adult onset OCD. However, there is no definite explanation for this hypothesis [4, 5].

Causes of OCD – What Is Going On in the Brain of Someone with OCD?

OCD is the dysfunction of the cortico-striato-thalamo-cortical (CSTC) circuit, which is summarized in the following image [6]:

Neurotransmission is more sensitive to environmental triggers in OCD patients because their genetics increases vulnerability. Imbalances in the CSTC transmission result in the physical production of OCD symptoms. Source: http://www.nature.com/nrn/journal/v15/n6/full/nrn3746.html

Patients with OCD have a disproportionately high blood cortisol level (stress hormone). The vulnerability of OCD patients to chronic stress causes significant changes in goal-directed behaviors, abilities to interact with the environment, and decision-making skills [7].

OCD is associated with other areas of the brain (amygdala, hippocampus, frontal cortex, limbic region) and several pathways (temporo-limbic system, orbitofrontal-subcortical loops) [6, 8, 9].

It is often necessary to try more than one therapy before finding an effective treatment.

Neurotransmitters, Inflammatory Biomarkers, and Hormones Involved in OCD

1) Glutamate Is Increased and GABA Decreased in the Brains of OCD Patients

Animal and imaging studies of patients with OCD reveal that there is increased glutamate (excitatory neurotransmitter) activity in the brain [10, 11].

Blood testing shows a decreased GABA (inhibitory neurotransmitter) levels in patients with OCD and other mood disorders [10].

The SLC1A1 gene codes for transporters that clear glutamate from the synapse of neurons, and it helps to make GABA [12].

Without SLC1A1, mice had significantly less GABA and increased glutamate and exhibited OCD behaviors [12].

After injecting ketamine, a substance that blocks glutamate receptors, patients had a rapid reduction in OCD symptoms [13].

There was also an increase in GABA which was positively correlated with the resolution of OCD symptoms [14].

Interestingly, glutamate also has some anti-anxiety effects when it activates the kainite receptors [15, 16].

2) Low Serotonin May Cause OCD

In rats, an SSRI that increases serotonin (clomipramine) in the brain (midbrain and hypothalamus), helped reduce the symptoms of OCD [17].

3) High Dopamine May Lead to OCD

Human and animal studies using both medication and imaging support the role of increased dopamine in OCD [2].

In an animal study, mice with high dopamine have more signs of OCD [18].

Another study found that quinpirole, which increases dopamine release, led to significant increases in compulsive behavior in rats [19].

4) Sex Hormones Affect Serotonin and Decrease OCD Symptoms

Progesterone is lower during the premenstrual period and menopause, which might be the cause in the flair of symptoms.

Estrogen and progesterone can enhance serotonin activity, which decreases symptoms of OCD [20].

Progesterone has some pro- and anti-anxiety effects [21, 22]. When converted to allopregnanolone & pregnanolone, which are potent activators of GABA receptors, it has anti-anxiety effects [2324]. In rats, progesterone can also improve GABA function [25].

Fluctuations of these hormones (ex. during reproductive events) cause changes in OCD symptoms. Women with OCD were surveyed about these changes and about half (49/101) reported an increase in symptoms during the premenstrual period and 9 during the menopause. During pregnancy, 17 reported worsening of symptoms and 11 patients reported improvement [26].

In one study of 30 people, testosterone was lower in men with OCD, but it was not statistically significant [22].

5) HPA Axis Hormones are Elevated in Patients with OCD

The hyperactivity of the HPA axis, which is seen in OCD patients, causes an increase in the release of certain hormones. These include corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH) and cortisol.

In a study with 23 children with OCD, higher early-morning cortisol values were found when compared with healthy people. Cortisol levels in the OCD group were reduced in response to a psychological stressor (exposure to a fire alarm), while an increase was found in healthy controls [27].

Elevations of these hormones cause a stress response, which leads to the release of inflammatory biomarkers [28].

6)  Inflammatory Biomarkers and OCD

Compared with healthy controls, 40 patients with OCD had significantly increased levels of inflammatory markers (CCL3, CXCL8, sTNFR1) [29].

However, in a meta analyses of 12 studies, OCD patients had lower blood levels of IL-1b [30].

Also, several studies show lower TNF-α [31].

OCD Risk Factors

1) Infection During Childhood

A pediatric autoimmune neuropsychiatric disorder associated with Streptococcus (PANDAS) can lead to compulsions, tics, or other psychiatric symptoms. This occurs in children who develop rheumatic fever or Sydenham’s chorea (usually after a Streptococcus infection) [32].

Pediatric acute-onset neuropsychiatric syndrome (PANS) includes cases where Streptococcus is not involved and metabolic disorders or environmental factors are the triggers [33].

Individuals with PANDAS or PANS develop autoimmune antibodies to specific parts of their brain (basal ganglia). These antibodies cause inflammation of the basal ganglia neurons. This weakens the blood-brain barrier and other antibodies can leak into the brain, which leads to the symptoms of OCD [34].

2) Psychiatric Illnesses

Individuals with other psychiatric illnesses are at a higher risk for OCD [35].

Those who experienced abuse, either physical or sexual, or trauma in childhood are at an increased risk as well [36].

Tourette syndrome, which causes tics in individuals, is linked to patients with OCD and ADHD [37].

Is OCD Genetic?

Research supports that OCD is often inherited and passed down within families [38].

Of 18 studies following families with adults with OCD, 16 determined that OCD was familial [2].

A meta-analysis that included 24,161 identical and fraternal twin pairs found that both genetic and environmental factors are important in the development of OCD [39].

  • If you have a family member with adult-onset OCD, you are two times more likely to develop OCD than the other people without a family member with the OCD.
  • If you have a family member with childhood-onset OCD, you are 10 times more likely to develop OCD than those not related to someone with OCD [40].

In childhood-onset OCD, 40 to 65% of symptoms are inherited. In adult-onset OCD, 27 to 47% are inherited [41].

Symptoms and Diagnosis of OCD

Diagnosing OCD can be difficult because individuals often feel shame and are secretive about their symptoms [42].

The staging of the disorder is:

Obsession → anxiety → compulsion → relief [43]

Various obsessions include:

  • Inability to let go of thoughts
  • Aggression
  • Contamination
  • Pathologic doubt
  • Religion
  • Self-Control
  • Sexual
  • Superstition and symmetry
  • Exactness

These symptoms are internalized by the individual and then they present themselves as compulsions [44].

For example:

  • An individual who is obsessed with dirt/germs will have compulsive behaviors like washing or cleaning rituals
  • A person who is obsessed with symmetry and exactness will have compulsive behaviors like ordering and arranging
  • A person with sexual or self-control obsessions will avoid situations that trigger the thoughts. They have mental rituals that they employ to counteract these thoughts or isolate themselves [44]
  • An individual who chronically has looping thoughts about particular subjects that they can’t get out of their mind.

Compulsions may not be as obvious as these examples. Most often, individuals have mental rituals, which they are reluctant to report due to stigma or embarrassment [42].

Treatments for OCD

Mainstream Behavioral Treatments for OCD

1) Cognitive Behavioral Therapy (CBT) Allows Patients to Cope with OCD

CBT has proven to be an effective method for treating OCD [45].

In a meta-analysis of 16 RCTs with 756 participants total, the scientists saw a large effect size for both adults and adolescents who underwent CBT. This means that when all the studies were pooled, CBT was positively correlated with the improvement of OCD symptoms [46].

2) The Exposure and Response Prevention (ERP) Method Significantly Reduces OCD Symptoms

With ERP, a patient is first exposed to triggers and then should learn skills to stop the compulsions. The exposures can be images or descriptions that are read repeatedly to desensitize patients from their obsessions. By addressing both obsessions and compulsions, ERP has been proven to be more effective than addressing either one alone [47].

Traditional Drug Treatments for OCD and Their Limitations

Note: SelfHacked is not endorsing that our readers take any drugs. We are just posting this because we think it’s interesting to know what the mainstream drug treatments are and if they are effective. Our philosophy is to try more natural/safe treatments before using drugs or less safe treatments. Before taking any substance, please discuss it with your doctor.

1) Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are the first line treatments for OCD because they have fewer side effects [45].

One in five patients who take SSRIs for OCD has at least a 25% reduction in symptoms compared to placebo. Most people respond to SSRIs after six weeks; however, it is recommended to try the medication for at least eight to twelve weeks to have an effect. Evidence suggests that in order to avoid relapse, about six to twelve months of therapy is necessary [48].

Head-to-head trials between several SSRIs including fluvoxamine, paroxetine, citalopram, sertraline, and fluoxetine showed no difference in efficacy [R, R, 49].

Each SSRI works slightly different from the other, therefore therapy is individualized to each patient’s characteristics. For example, fluoxetine may be preferred in those who forget to take their medication daily since it lingers in the body for weeks [50].

Overweight patients would benefit from either fluoxetine or sertraline since they are both associated with the lowest weight gain [51].

Citalopram can increase the risk of heart abnormalities with daily doses of over 20 mg. A recent study disproved this elevated risk to the heart; however, if an individual is suffering from heart issues, it may be in his/her best interest to avoid citalopram and use a safer SSRI [52].

A recent meta-analysis showed that high doses of SSRIs were associated with greater efficacy than low or medium doses [53].

There are limitations to SSRIs. They often do not completely resolve all symptoms of OCD, and they have a two to three month lag time to achieve their full effect [54].

Of note, all antidepressants have an FDA issued black box warning for a potential to increase suicidal thoughts when starting antidepressants. It is important to contact a medical provider if this occurs [55].

There are also side effects involved with SSRIs that can be remembered as the 7 S’s:

  • Stomach upset (nausea)
  • Sleep disturbances
  • Sexual dysfunction
  • Stress (mostly agitation)
  • Serotonin syndrome (caused by too much serotonin usually presents as an intense headache, flushing, muscle rigidity and diarrhea – rare)
  • Size increase (weight gain)
  • Suicidal thoughts

Similar symptoms may also occur as during withdrawal when discontinuing SSRIs [56].

2) Tricyclic Antidepressants (TCA)

Clomipramine is a TCA and FDA-approved drug for OCD. It blocks the reuptake of serotonin, norepinephrine, and dopamine [57].

Clomipramine has fallen out of favor because there are drugs that are more effective and have fewer side effects [57].

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Less Traditional Drugs for the Treatment of OCD

1) Memantine Blocks Glutamate Transmission in the Brain

Memantine, a medication used for Alzheimer’s disease, blocks NMDA receptors, which reduces glutamate’s effects in the brain.

In a study (DB-RCT) on 38 patients, fluvoxamine (SSRI) + memantine was compared to fluvoxamine + placebo in patients with moderate to severe OCD. Approximately 89% of the patients in the memantine group patients no longer had OCD symptoms after eight weeks compared with 32% in the placebo group [58].

2) Ketamine Relieves Obsessions in Adults with OCD

Ketamine blocks glutamate receptors (NMDA). In 15 untreated adults (DB-RCT) with OCD received an infusion of either salt water or ketamine. There were reports of significant improvement in obsessions after the ketamine infusion and 50% still maintained this improvement one week later [59].

3) Ondansetron Can Improve Fluoxetine Treatment

Ondansetron is helpful for nausea by blocking certain serotonin receptors. In an eight-week pilot study, ondansetron + fluoxetine was compared to placebo + fluoxetine. There was a significant decrease in symptoms in the ondansetron group versus the placebo group [60].

4) Mirtazapine Decreases Symptoms of OCD

Mirtazapine is an atypical antidepressant, which increases serotonin in the brain differently from SSRIs.

In a 12-week study of 30 people taking 60mg mirtazapine (DB-RCT) found that mirtazapine outperformed placebo and decreased symptoms by about 20%. A bit over half of the people improved with the treatment[61].

5) Pregabalin and Gabapentin Help to Alleviate Symptoms of OCD

Gabapentin and pregabalin are used for nerve pain and as anticonvulsants to prevent seizures. They are structurally similar to the neurotransmitter GABA, and are thought to enhance GABA’s effects [62, 63].

One study showed that gabapentin + SSRIs was better at alleviating early symptoms of OCD than an SSRI alone [64].

A case series of 12 patients also showed that OCD therapy with pregabalin reduced symptoms by 26%. The only side effects were dizziness and fatigue [65].

6) Mood Stabilizers (Lamotrigine and Topiramate) Decrease Negative Symptoms in OCD

Lamotrigine and topiramate both inhibit the actions of glutamate and have been studied as adjunctive agents for OCD.

A study of 41 OCD patients who failed their first trial of an SSRI were given topiramate or placebo with an SSRI. There was a 32% decrease in OCD symptoms in the topiramate group and only a 2.4% decrease in symptoms in the placebo group [66].

Although this seems promising, there is very little evidence for topiramate, and it does have adverse effects in the brain such as paresthesias (abnormal burning or prickling sensation) [66].

Lamotrigine decreases symptoms of observable obsessions and compulsions when used along with an SSRI. The main adverse events included headaches and skin rash. Lamotrigine can cause a deadly hypersensitivity reaction in the form of a rash called Stevens-Johnsons Syndrome (SJS), so it is important to monitor closely [67, 68].

7) Amphetamines May Be Beneficial for Short-Term OCD Treatment

Stimulants may have a role in the treatment of OCD, especially with co-occurring ADHD. A single dose of d-amphetamine (RCT) had short term benefits in resolving OCD symptoms [69].

In another study, d-amphetamine was compared to caffeine and both compounds rapidly improved OCD symptoms within a week [70].

8) Clonazepam Decreases Anxiety in OCD Patients

Many people regret going on benzodiazepines because they build up tolerance quickly and are hard to stop, so this is something you need to be very cautious about.

Clonazepam, clonidine, and clomipramine (TCAs) were compared to the control diphenhydramine (Benadryl). Roughly 40% of patients whose symptoms were not resolved with clomipramine had a clinically significant response to clonazepam [71].

Clonazepam may be helpful in relieving symptoms of anxiety, but, it should be used with caution in patients with previous benzodiazepine or other substance abuse histories [71].

9) Opioids May Have an OCD Benefit (If Used Carefully)

Opioid drugs are often effective in various mental illnesses and some promise in treatment-resistant OCD; however, given their addictive properties, they should be used with extreme caution [72, 73].

Naloxone, an opioid receptor blocker, exacerbated symptoms of OCD, while tramadol, which activates opioid receptors, relieved OCD symptoms [74].

There are some natural ways to increase opioids.

10) Riluzole Decreases Symptoms of OCD

Riluzole, which is used in ALS, decreases the neurotransmission of glutamate [75].

Riluzole + SSRIs has been shown to be effective at decreasing symptoms significantly in patients with treatment-resistant OCD [75].

11) Benadryl

One study with 28 people used Benadryl (diphenhydramine) as the placebo, because it was assumed that it wouldn’t have an effect on OCD. However, Benadryl caused a significant decrease in symptoms [71].

There need to be further studies done before Benadryl can be considered a potential treatment.

More Invasive (Highly Questionable) Treatments for OCD

These treatments are very serious and can have permanent side effects, so we decided to separate them.

1) Repetitive Transcranial Magnetic Stimulation (rTMS) Decreases Signs and Symptoms of OCD

rTMS introduces a magnetic field pulse to the brain, which affects neuronal activity [76].

A meta-analysis published of 10 RCTs included 282 subjects with OCD. About 35% for the group receiving active rTMS had a decrease in symptoms, versus 13% for those receiving fake rTMS [77].

The short-term side effects were localized pain, burning, or prickling sensation (paresthesia), hearing changes, thyroid stimulating hormone and blood lactate level changes, and hypomania ( a mild form of mania).

In rare instances, high-frequency rTMS can cause seizures [76].

2) Deep Brain Stimulation (DBS) As a Last Resort

There have been some case studies of an invasive strategy where electrodes are surgically implanted in the brain and then send localized electric impulses [78].

The average overall response rate to DBS is about 50%. The studies reported limited side effects and concluded that DBS was relatively safe [79].

However, other adverse events have been reported, including [80]:

  • Bleeding in the brain (without symptoms)
  • Seizure (one case report)
  • Superficial infection
  • Hypomania
  • Worsening of depression
  • Worsening of OCD
  • Short-term sadness
  • Short-term anxiety
  • Short-term euphoria or giddiness

3) Ablative Neurosurgery Alleviates Symptoms of OCD

With the new technology, surgical procedures are more accurate and have less negative effects. Currently, there are two ablative surgical procedures offered, each creates lesions on a specific part of the brain which alters brain circuitry [81].

There is minimal evidence for this procedure, since it is newer and is mostly used for severely resistant OCD. These procedures helped 30 to 60% of patients with highly resistant OCD [81, 82].

Natural and Alternative Treatments for OCD

At SelfHacked, we think that natural and safer treatments are the best place to start when biohacking OCD.

1) Inositol May Improve Anxiety and Depression in OCD

Inositol, a component of cell membranes, is involved in cell communication and also increases the sensitivity of serotonin receptors [83].

A six-week study of 10 OCD patients compared 18 g of inositol to placebo. Anxiety and depression symptoms improved with inositol and there were very few side effects (mostly GI) [84, 85].

Although the scientific data is limited, many people report positive effects with inositol, including in children (see the bottom of the post).

The benefits of trying inositol appear to outweigh the risks.

2) N-Acetyl Cysteine (NAC) Improves OCD Symptoms

A 12- week study of 50 patients diagnosed with trichotillomania (hair pulling; which is on the OCD spectrum) compared 1200 to 2400 mg of NAC to placebo. About 56% of the patients were found to be “much or very much improved” compared with only 16% of the placebo group [86].

In a systematic review of four clinical trials using NAC for 12-weeks (2,400–3,000 mg/day) found that NAC reduces the severity of symptoms in OCD [87].

NAC adds to the effects of SSRIs (citalopram) in improving resistance to compulsions in OCD children and adolescents. This is based on 10-week trial with 34 OCD patients (DB-RCT) [88].

Nausea is a common adverse effect, and this can be reduced or eliminated if taken with food; however, no adverse effects were reported in this study. NAC has a benefit that medical professionals are familiar with it, since it is often used in the medical setting, and it appears to be relatively safe in pregnancy [89].

NAC is thought to work by decreasing glutamate in the synapse and increasing glutathione [90]. Low glutathione in certain brain regions (cingulate cortex) have been found in patients with OCD [91].

Bottom line: NAC appears to be beneficial in OCD and with low risk.

3) Glycine Is Helpful for Relieving OCD Symptoms

Glycine is an amino acid that reduces glutamate function in the cortical region of the brain [92].

In a 12-week study, 24 OCD patients were given 60 grams of glycine or placebo daily along with their regimen. Ten patients dropped out of the study due to bad taste and nausea with the glycine. Overall, there was a minor decrease in OCD symptoms [92].

Glycine tastes sweet, but I assume that the very high dosage is what may have caused the nausea. It’s probably best to experiment with 10 grams or less to reduce side effects (nausea), and it might still help. Glycine is healthy and has very low risk, so it’s worth the experimentation.

4) Caffeine Helps Improve OCD Symptoms

In a five-week double-blind trial with 24 patients, 300 mg of caffeine or 30 mg dextroamphetamine were added to their current OCD regimen. OCD symptoms decreased by 55% in caffeine group vs, and 48% in the dextroamphetamine group. All patients completed the study without adverse events [93].

5) Milk Thistle Decreases Symptoms of OCD

Milk Thistle is a plant with the flavonoid silymarin that increases the levels of serotonin in the cortex of mice [94].

In one 8-week-long study (RCT), 35 patients were given 200 mg milk thistle three times daily or 10 mg fluoxetine three times daily. Fluoxetine proved to be more effective than milk thistle, however, they both significantly decreased symptoms of OCD [95].

Milk thistle was almost as good as the SSRI, with minimal side effects. It appears to be safe and moderately effective for OCD.

6) Borage Oil Decreases Anxiety in OCD Patients

Borage is a plant whose flower and oil are both used for OCD. It has anti-anxiety effects similar to benzodiazepines (ex. Valium) in mice models [96].

A six-week trial was conducted on 44 patients who received either 500 mg daily of borage extract or placebo. At week four and six, the borage group and significantly reduced OCD symptoms and a decrease in anxiety [97].

However, borage may cause liver toxicity, diarrhea, vomiting, headaches, worsening of asthma and may be harmful in pregnancy. It is not an optimal choice, especially in patients with liver damage or who are pregnant [98, 99].

7) The Probiotic Bifidobacterium Longum Is Helpful for OCD Symptoms

Changes in the gut bacteria have been linked with anxiety disorders and OCD specifically. Mice that were administered probiotics for 30 days and then injected with a substance that induces OCD symptoms had fewer symptoms than the mice injected with salt water [100].

A study was done in 25 healthy subjects (without OCD and had low urine cortisol levels) where clinicians assessed the subjects for stress, anxiety, obsessive-compulsive behavior, and paranoid ideation using surveys. After 30 days, the group which took Bifidobacterium longum (a probiotic) daily scored lower on these surveys than they did prior to starting the probiotic [101].

8) Zinc Decreases Obsessions When Used with Fluoxetine

Scientists have discovered that zinc may play a role in inhibiting excitatory neurotransmission, and activates multiple receptors including GABA [102, 103].

Zinc was found to be 69.2% lower in mild OCD patients than non-OCD patients [104].

An eight-week study conducted on 23 OCD patients compared zinc + fluoxetine to placebo + fluoxetine. The zinc group decreased obsessions and compulsions over eight weeks faster and with greater effect without an increase in adverse effects [105].

9) Iron Supplementation May Reduce Symptoms of OCD

Blood iron levels in patients with mild and moderate OCD are between 41 – 44% lower than non-OCD patients [104].

Low iron is correlated with higher tic severity in Tourette syndrome. A study showed that iron supplementation decreased the severity of tics over six to twelve months. Since there is a relation between Tourette syndrome and OCD, iron supplementation may help for OCD [106].

10) Manganese and Calcium Chelation Improves OCD Symptoms

Moderate OCD patients have 62% higher manganese blood concentration and 12% higher calcium blood levels than non-OCD patients [107].

Normal calcium blood levels are required in OCD because calcium is necessary for cellular communication, and calcium levels affect the clinical response to SSRIs [108].

Carnosine is a gentle and healthy anti-aging supplement to help chelate extra minerals.

11) Music Helps Decrease Symptoms of OCD

Music therapy helped to alleviate symptoms of obsession and anxiety in 30 patients who were all already being treated for OCD. The effects were seen in one month, suggesting that music therapy may be helpful as a more acute therapy [109].

12) St. John’s Wort Helps OCD

St. John’s Wort (SJW) is well-known as an alternative treatment for various psychiatric conditions. It acts as a serotonin reuptake inhibitor, therefore blocking the breakdown of neurotransmitters such as serotonin, and it also increases the sensitivity of receptors in the brain to neurotransmitters [110].

There are mixed results in the few trials studying SJW in OCD. Therefore conclusions may not be drawn on the efficacy of SJW in OCD yet [111].

It is important to note that SJW does interact with several other common medications and can increase the risk of bleeding, therefore it is important you consult with your healthcare provider if you are considering initiating this treatment [112].

Mind-Body Interventions Help OCD Patients

1) Meditation May Be Helpful for OCD

Mindfulness meditation is thought to help individuals with anxiety by helping them mentally avoid their triggers. A pilot study with 17 participants showed a reduction in OCD symptoms in patients who partook in mindfulness meditation [113].

Meditation is harmless if practiced properly and may be beneficial to other psychological aspects of life [114].

2) Exercise Helps Reduce OCD Symptoms

Two small studies have assessed the effects of exercise on participants stabilized on OCD therapy. One study found that a regular walking exercise reduced OCD symptoms at six weeks and a month later [115].

The next study found that moderate-intensity aerobic exercise significantly reduced obsessions and compulsions at the end of the first week but not at the end of week 12 [116].

Due to the lag time of many medications, acute therapies are just as essential as chronic therapies and exercise is definitely something people should try first.

Potential Natural Treatments Lacking Clinical Evidence

Reducing anxiety may be a beneficial approach to eliminating symptoms of OCD. Read our post on the Top 31 Natural Treatments for Anxiety for more information.

1) Supplements to Increase GABA and Reduce Glutamate Help with OCD Symptoms

Read these posts to learn how to increase GABA and to decrease glutamate.

2) Vitamin D Deficiency Is Common in OCD Patients

Reports suggest that vitamin D may play a large role in many of our bodies’ processes including our immune system [117].

Children with OCD are more likely to have vitamin D deficiency and of those, there is a higher rate of ADHD [118].

One case report of a 7-year-old boy had vitamin D deficiency and took 800 IU a day along with his SSRI for OCD. His cleaning obsessions were almost resolved after one month; after four months most symptoms of OCD resolved [119].

Vitamin D is necessary for overall health, it is difficult to overdose, and has minimal adverse effects. Therefore, it’s a good option to try for OCD.

3) Magnesium Is Lower in OCD Patients

Magnesium levels are lower in patients with OCD and magnesium deficiency has been linked to increased excitatory neurotransmission. Studies suggest that magnesium supplementation may be helpful in Tourette syndrome, which is often linked with OCD [107, 120].

4) Acupuncture May Improve Symptoms of OCD

Acupuncture increases serotonin transmission and exerts pain-relieving effects via the opioid receptor [121].

One pilot study did show some decrease in symptoms in the acupuncture group versus placebo in patients with OCD [122].

5) Nicotine Might Relieve OCD Symptoms

In a series of five case studies of non-smoking individuals, nicotine patches helped to relieve symptoms of OCD. The results varied between patients, therefore it is difficult to draw any conclusions. Given the risks of nicotine use, the risks and benefits should be evaluated with a physician prior to initiating this treatment [123].

6) Light Therapy Might Help with OCD

A single case report exists of a woman who developed OCD during the winter season. She also had seasonal affective disorder (SAD). Light therapy was an effective treatment for SAD and doctors prescribed 30 minutes of light therapy for five days. After two weeks, the woman felt a noticeable difference and no longer had symptoms of obsession [124].

7) Tryptophan or 5-HTP May Be Beneficial for OCD

Tryptophan is the precursor to 5-HTP, which is the precursor to serotonin. Either tryptophan or 5-HTP supplementation may help to relieve symptoms of OCD by increasing serotonin. 5-HTP can more easily cross the blood-brain barrier than tryptophan and has evidence in the treatment of depression and anxiety [125, 126].

8) Bacopa Decreases Cortisol

Bacopa decreases cortisol levels in humans and can decrease stress and anxiety [127].

Patients with OCD may benefit specifically from bacopa because they have chronically elevated cortisol [7].

9) Cannabidiol Reduces Anxiety

Cannabidiol (CBD) lacks the psychoactive effects of THC. It is helpful in relieving stress and anxiety; therefore, may be of benefit to relieve these symptoms in OCD [128].

People’s Experiences with OCD Treatments

Experiences with Treating OCD in Children

“…we started N-acetylcysteine with my son. It was not a consistent immediate response for him and improvement increased over time even after we reached our twice a day dose. For the last few months, my son has been, for all intents and purposes, free of any life impeding symptoms. I rarely saw any hint of OCD and, even then, the anxiety level associated is almost nothing for him. I’m not sure he would even be able to be diagnosed as he is now”.

“…We tried Inositol but I don’t think we gave it enough chance and things deteriorated so quickly that we resorted to Zoloft. It’s been a year now, and although much better, my son is definitely NOT symptom-free by any means. We were going to try weaning him off and try St. John’s Wort instead”.

“My child was diagnosed with OCD almost three years ago. She was on Zoloft for a year and I decided to wean her off and try some natural supplements. We used N-acetylcysteine for a bit but didn’t see too much improvement. We started using L-tryptophan and supporting supplements and saw great results. We were able to stop those supplements as well after another year. Now we have very little OCD symptoms left and the anxiety is much better but still around a bit at bedtime. This all started with the onset of puberty”.

Experiences with Treating OCD in Adults

“I’ve had severe OCD since I was around 4 years old or so and only got relief about two years ago (I’m 45) from medication. I never even knew there was medication available. My doctors think I have chronically low serotonin levels (which evidently is somewhat rare). By using an SSRI my life has changed dramatically” [129].

“I acquired OCD at the age of 19 and it progressively got worse until I decided to take some action. I am currently 25 and I have mitigated the aversive effects to the point where it is more manageable and tolerable. Here are some tips that I have found have worked: Prescription drugs made me feel drowsy and “drugged”, I tried taking them but I found they diminished clarity of mind. Paying attention to diet definitely helped. I found decreasing or even eliminating certain food had an enormous benefit. Foods to avoid are sugar (accept naturally occurring ones in fruit, honey, maple syrup), meat and bread, along with packaged foods and junk food. Consider eating more fruits, vegetables, and nuts. I found that yoga and meditation really helped me to quiet and lessen all the mind chatter. Exercise is also a big plus” [130].

“I’ve been on various AD’s (antidepressants) since I was about 18 as I’ve had OCD pretty much since puberty hit. These drugs include Prozac, Cipramil, Lexapro, and Effexor. Also Zyprexa and antipsychotic. None of these did a thing for OCD, even at high doses…When my new psychiatrist recently put me on to Anafranil (clomipramine) I was a little worried as he explained to me that these types of drugs are more effective, however a lot worse side effects!! But I decided to go ahead with it…all I can say is that Anafranil is the only drug that has EVER worked for OCD and I can say that I am 99% cured” [131].

“Lately I’ve been taking CBD oil and it’s has helped me feel better. It is natural and a lot of people have success with it” [132].

“I don’t take any vitamins…I’ve tried many and they never helped” [132].

“I am on Paxil CR for OCD, it’s been 7 weeks 50mg/day still seeing no positive effects from the medicine” [133].

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