OCD Treatment in Palm Beach
ERP therapy and medication management for obsessive-compulsive disorder
What Is Obsessive-Compulsive Disorder (OCD)?
Obsessive-Compulsive Disorder involves recurrent, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed to reduce anxiety. OCD is not about being neat or organized — it is a debilitating cycle of distress and temporary relief that can consume hours each day.
Signs & Symptoms
- Contamination fears and excessive washing/cleaning
- Symmetry obsessions and arranging/ordering compulsions
- Harm obsessions (fear of hurting self or others)
- Religious or sexual intrusive thoughts
- Checking behaviors (locks, appliances, errors)
- Mental compulsions (counting, praying, reviewing)
- Hoarding symptoms
- Time consumed by obsessions/compulsions (>1 hour/day)
Treatment Approaches
Exposure and Response Prevention (ERP) therapy is the gold-standard treatment for OCD, systematically exposing patients to feared situations while preventing compulsive responses. SSRIs (particularly at higher doses) and clomipramine are effective pharmacological options. Dr. Agresti can manage complex OCD presentations requiring augmentation strategies.
Why Concierge Psychiatry?
With Dr. Agresti's concierge model, you get his direct cell number, same-day prescription refills, and 24-hour appointment availability — with no membership fee. Experience the difference that direct-access care makes.
Learn About Concierge CareFrequently Asked Questions
OCD typically requires higher SSRI doses than depression, and full therapeutic response often takes 8-12 weeks at the target dose. This is longer than the 4-6 weeks typical for depression treatment. Patience during titration is essential, and Dr. Agresti's concierge model allows direct communication during this period so dose adjustments can happen efficiently.
For treatment-resistant OCD, augmentation strategies include adding low-dose atypical antipsychotics (risperidone or aripiprazole), clomipramine, or glutamate modulators. Dr. Agresti specializes in complex psychopharmacology and has over 30 years of experience managing difficult-to-treat OCD cases that haven't responded to first-line approaches.
Yes, OCD themes frequently shift. A patient who initially has contamination obsessions may later develop harm-related or religious obsessions. The underlying mechanism — the cycle of intrusive thoughts, anxiety, and compulsive relief-seeking — remains the same even as content changes. This is why treatment targets the OCD cycle itself rather than specific themes.
The DSM-5 classifies OCD separately from anxiety disorders in its own category, recognizing its distinct neurobiology involving cortico-striatal-thalamic circuits. However, OCD frequently co-occurs with anxiety disorders, depression, and ADHD. A comprehensive psychiatric evaluation identifies all co-occurring conditions so treatment can address the full clinical picture.
While OCD often begins in childhood or adolescence, adult-onset OCD is well-documented. Onset can be triggered by major life stressors, pregnancy/postpartum periods, or medical illness. Some adults have had subclinical OCD symptoms for years that worsen under stress. Regardless of when symptoms begin, both ERP therapy and medication are effective treatments.