online conference transcript

Dr. Alan Peck has been working with OCD patients for over 20 years. He participated in the transition from therapy-only treatment to the addition of OCD medications. Dr. Peck helped bring the first drug that was authorized for Obsessive-Compulsive Disorder, Anafranil, into the U.S. in 1980.

David Roberts is the HealthyPlace.com moderator.

The people in blue are audience members.

David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. Our topic tonight is OCD (Obsessive-Compulsive Disorder). Our guest is psychiatrist Alan Peck.

Dr. Peck has been working with OCD patients for over 20 years and has participated in the transition from mostly therapy-only treatment for Obsessive-Compulsive Disorder to the addition of a number of medications that provide relief. In fact, Dr. Peck helped bring the first authorized drug for OCD to this country, Anafranil (Clomipramine), nearly 20 years ago. For more info you can visit Dr. Alan Peck website.

Good evening Dr. Peck and welcome to HealthyPlace.com. Thank you for being our guest tonight. You call Obsessive-Compulsive Disorder one of the most emotionally painful psychological problems that exist. What makes that so?

Dr. Peck: The continual and usually bothersome thoughts in the obsessional mode is painful. The compulsive aspect, although not as common, can be life limiting.

David: What are the most effective treatments for OCD?

Dr. Peck: Obsessive thoughts are usually foreign in nature and can be often opposite to what a person wants to feel. I believe medication is the most effective treatment. Cognitive therapy is helpful as well, in that it can educate a person to understand his/her disease.

David: And which OCD medications are we talking about? Can you mention them by name?

Dr. Peck: Probably the most effective medication is Anafranil (Clomipramine)--or clomipramine. Many of the SSRI medications or new generation of antidepressants are helpful such as Prozac, Zoloft, Paxil, etc. Luvox is the SSRI that has been authorized by the FDA as the accepted SSRI for OCD but all, I feel, are useful.

Other drugs may be helpful as well . For example, an anti-anxiety drug, such as Xanax, could control the anxiety caused by bothersome thoughts.

David: Do you think that OCD can be effectively treated by therapy only, without medications?

Dr. Peck: Perhaps a mild case but when there is emotional pain, medications are necessary.

David: And how about vice versa? The medications without the therapy? Is that effective?

Dr. Peck: Yes, but after an understanding of the patient occurs. Then medications may suffice.

David: Here are some audience questions, Dr. Peck:

Chris10: I've been on Luvox, Prozac, Celexa, and none of them worked. Now, I just started Zoloft. Is it unusual to have a hard time finding a medication that works for you?

Dr. Peck: Yes, it can be a difficult time. I would urge a trial of Anafranil.

Chris10: My doctor won't put me on Anafranil. He says there are too many side-effects. Is that true?

Dr. Peck: That is not true. For some reason, at least in my practice, side-effects in OCD patients have not been a serious problem. Perhaps the relief from Anafranil hides the side-effects.

David: For a more detailed look at the various OCD medications, their effects and side-effects, you can for our medications chart.

LexuskelA: I would like to ask a question about medications for OCD that do NOT involve side effects of throwing up or nausea. I have a HUGE fear of throwing up and I have decided to go on medications. I want to know what ones are best.

Dr. Peck: Of the SSRI medications, Celexa appears to have the least side effects, next would be Luvox and then Serzone.

megstar: How many different types of OCD (Obsessive-Compulsive Disorder) are there?

Dr. Peck: Interesting question. I think there are many types. The true classic type of obsessions and compulsions are not that common. At least 25% of people who are obsessional, do not have any compulsions. Then, there are degrees of this.

David: Are there factors, such as smoking, drinking, stress, etc., that enhance the effects of OCD?

Dr. Peck: OCD was first thought of as a type of anxiety problem. In later years, it was believed to be somehow connected with depression. I believe anxiety is involved here. And then stress, drink and smoking, I believe, affect anxiety levels and hence OCD.

I believe too, that many problems such as OCD, can be environmental. Living with someone with OCD can become the theme of the family. Getting away from it may help.

David: And that's a good point Dr. Peck. How can friends and family members help OCD sufferers, or is it really something they have to handle on their own?

Dr. Peck: If you trust your family or loved one, then they can help by gently encouraging you to not be as intense, to remind you that you are showing signs of OCD.