Is Behavior Therapy or Drug Therapy Best for OCD?

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We generally start with behavior therapy particularly in children, the evidence for the effectiveness of medications for OCD in children is not as strong as it's in adults and you want to avoid the side effects if possible. So for the most part of it, if it's a child or adolescent with OCD will start behavior therapy.

In adult it's really a discussion between the patient and the therapist and I try to present the pros and cons of the behavior therapy versus the medication, then I also take in account another core more of these symptoms, so somebody with OCD who also has serious depression.

They may not be able to adhere to all the requirements of homework of doing behavior therapy, in that case we might start with medications first.