Assisting Obsessive Compulsive Disorder (OCD) Patients With Discontinuing Long-term Serotonin Reuptake Inhibitors (SRIs)

Inclusion Criteria:

1. 18 or older

2. Presence of mild to moderate OCD symptoms

3. Patient's treating clinician agrees that SRI discontinuation is clinically appropriate

4. Adequate trial of SRI (≥10 weeks) in the current treatment episode

5. Maintenance on SRI dose that has not increased due to significant clinical worsening
in the two years prior to enrollment

6. English speaking

Exclusion Criteria:

1. Clinically significant suicidality or a suicide attempt within the past year

2. Presence of any clinical features warranting a higher level of care (partial or
inpatient hospitalization)

3. Current or recent (past 6 months) alcohol or drug dependence or abuse

4. Current or past psychotic disorder or bipolar disorder

5. Moderate to severe depression, as indicated by a Hamilton Rating Scale for Depression
(HRSD) (17-item) ≥ 14 or recent major depressive episode (past 6 months)

6. History of severe OCD (YBOCS ≥ 28)

7. Prior adverse experience with SRI discontinuation

8. Primary compulsive hoarding

9. Cognitive impairment that would interfere with study participation

10. Concomitant psychosocial treatment w/ proven efficacy in the treatment of OCD

11. Previous adequate trial of exposure-based treatment (e.g., history of 12 or more
sessions) in past 5 years

12. Use of non-SRI psychotropic medications for OCD in the 3 months prior to enrollment.