My wife have a problem of frequent hand washing for 3 years. Doctor recognised that is OCD. At first doctor trying to solve the issue with Behaviour Therapy , counseling but it doesn't working anymore. Now doctor suggested to go with medicine. Now questions are much time required to cure with medicine and how does it works ? How long medicine can continue ? Is there any side effect of these medicine ? What will happen it medicine stops ? Is she has to continue medicine entire life ?

Dr. Saul PereiraPsychologist46yrs exp

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Ocd is based on fear of an abnormal kind. You have done the right thing by trying cbt and since that has not produced the desired effect, it is time to include medication. This can become a very crippling disease and you should not burden yourself or your wife with the length of time for the treatment. All psychotropic drugs have side-effects. So you will have to bear with that and focus on the main problem. Please take her parents with you to determine the possible developmental issues that may have contributed to this condition. This is a fear-based condition and for some reason, she has not been dealing with this childhood fear which has now developed into these repetitive adaptations to seem to need it for normal functioning. The behavior will then become based on magical thinking and certain rituals will become necessary to do normal things making her believe that either the frequency or the ritual is important to its success. This, of course, is a fallacy but there will come a time that even if told the truth, her belief will defy any logic and she will continue behaving like that even if it cripples her in her daily routines. It only appears as though some other force is behind these behaviors and that she is compelled to act in this fashion. That is obviously not true but no one can convince her of anything different. The obsession is a repeating thought pattern with no meaningful outcome; and the compulsiveness is the need to act on those obsessions also in a repeated behavior pattern as though she just cannot help herself, like the washing if hands. There are certain behavioral techniques to be implemented and if they work she may get out of this condition rather easily. If that does not work as desired, then medication has to be introduced, and in combination with counseling much work can be achieved. 

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