Obsessive-Compulsive Disorder: Neurobiology and the Latest in Treatment

Derick E. Vergne, MD


May 17, 2017

In This Article


OCD is a heterogeneous disorder that involves multiple asynchronous brain regions, with a net effect of reducing the influence of the neocortex (thinking brain) on emotional/motoric regions, which creates the redundancy seen in the illness. Different neurotransmitter systems have been implicated, including glutamate (the main excitatory neurotransmitter), serotonin, and dopamine.

SSRIs, anticonvulsants, and some atypical antipsychotics, such as risperidone at low doses, have shown efficacy in the treatment of OCD. The symptoms of the patient described at the beginning of this article improved significantly when low-dose risperidone and then adjunctive topiramate was added to his treatment regimen. Residual symptoms are currently being targeted with an SSRI.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.