OCD treatment in Hindi. OCD se bahar kaise nikale. OCD kaise thik hota hai. Treatment resistant OCD.

Описание: n this video, Dr. Mayank Agrawal (Psychiatrist, Mental Health Specialist) explains the management of Treatment-Resistant Obsessive-Compulsive Disorder (OCD).
Many patients with OCD do not respond well to standard SSRIs or CBT therapy, and this condition is termed treatment-resistant OCD. Dr. Agrawal discusses advanced evidence-based strategies including:

Role of higher SSRI doses and augmentation strategies

Use of antipsychotics in resistant OCD

Role of glutamate modulators

Neuromodulation techniques like rTMS and DBS

Importance of specialized CBT techniques (ERP)

Lifestyle and supportive management
Use of antipsychotics in resistant OCD

Step-wise Management of Treatment-Resistant OCD
Step 0 — Confirm the diagnosis
• Ensure it is truly OCD and not another disorder.
• Rule out comorbid conditions like depression, bipolar disorder, psychosis, or substance use.
• Use rating scales (like Y-BOCS) to track severity.
• Start or continue CBT with ERP (Exposure and Response Prevention).
Step 1 — Optimize SSRI treatment
• Use SSRIs at higher doses than for depression.
• Continue treatment for at least 12 weeks, with 4–6 weeks at the maximum tolerated dose.
• Common SSRIs and dose ranges:
Sertraline: up to 200–400 mg/day
Fluoxetine: 40–80 mg/day
Fluvoxamine: 200–300 mg/day
Paroxetine: 40–60 mg/day
Escitalopram: up to 20 mg/day
Step 2 — Switch strategy
• If one SSRI fails, try another SSRI.
• If multiple SSRIs fail, try Clomipramine (100–250 mg/day) with ECG and side-effect monitoring.
Step 3 — Antipsychotic augmentation
• Add a low-dose antipsychotic to SSRI or Clomipramine:
Risperidone: 0.5–3 mg/day
Aripiprazole: 5–15 mg/day
• Use for 4–8 weeks and monitor side effects.
Step 4 — Glutamate modulators (specialist use)
• Consider add-on options like:
Memantine 10 mg twice daily
N-acetylcysteine (NAC) 2–3 g/day
Lamotrigine 100–200 mg/day (slow titration)
Step 5 — Neuromodulation
• Deep TMS (H7 coil) – FDA cleared for OCD.
• rTMS (SMA region) – evidence-based noninvasive option.
• Delivered daily for several weeks.
Step 6 — Ketamine (experimental)
• IV ketamine 0.5 mg/kg can give rapid, short-term relief.
• May help in enhancing ERP therapy.

Step 7 — Surgery / DBS
• Deep Brain Stimulation (DBS) is considered in severe, chronic, disabling OCD after multiple treatment failures.
• Done only in highly specialized centers with strict criteria.
Step 8 — Maintenance & relapse prevention
• Continue effective medication for 1–2 years or longer.
• Regular booster ERP sessions.
• Reduce dose gradually only after long-term stability.

ocd bimari ko kaise theek karen, ocd bimari ko kaise dur karen, ocd kaise thik hota hai,
ocd kaise khatam kare,
ocd kaise dur kare,
ocd kaise thik hoga,
ocd kaise hataye,
ocd kaise kam kare,
ocd kaise khatam hoga,
ocd kaise roke,
ocd theek karne ke upay,
ocd theek karne ka upay,
ocd theek karne ka tarika,
ocd theek kaise karen,
ocd problem kaise theek karen,

ocd ko jad se kaise khatam ka ocd ko kaise control karen,
ocd ko kaise dur karen,
ocd ko kaise khatm karen,
ocd ko kaise roke,
ocd ko kaise theek kiya jaaye, ocd ko khatam kaise kare,
ocd ko khatam karne ka tarika ocd se bachne ke upay,
ocd se kaise bacha jaaye,
ocd se kaise bahar aaye,
ocd se kaise bahar nikale,
ocd se kaise bahar nikle,
ocd se kaise mukti paye,
ocd se kaise nikale,
ocd se chutkara kaise payen
ocd se chutkara
ocd se kaise chutkara paye
ocd se kaise nikle,
ocd ko bina dawa kaise theek ocd ko control kaise kare,

#OCD #TreatmentResistantOCD #ObsessiveCompulsiveDisorder #MentalHealth #Psychiatrist #OCDTreatment #CBT #ERP #rTMS #DBS #drmayankagrawal

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Disclaimer-The content on this video is offered only as information and it does not constitute solicitation or provision of Medical advice. The content here should not be used as a substitute for obtaining Medical advice from a licensed health care practitioner authorized to practice in your jurisdiction. You should always consult a qualified health care practitioner regarding any specific medical problem or issue.