What are the medication management options, including doses, for postpartum obsessive-compulsive disorder (OCD)?

From the Research

Medication Management Options for Postpartum OCD

• There are limited studies on the pharmacotherapy of postpartum obsessive-compulsive disorder (OCD) 1.
• One open-label trial found that quetiapine augmentation of SSRIs or SNRIs was effective in treatment-resistant OCD in the postpartum period, with 11 out of 14 patients responding to treatment within 12 weeks 2.
• The average dose of quetiapine required for response was 112.5 mg, with a mean reduction of 59.6% in Yale Brown Obsessive-Compulsive Scale (YBOCS) scores 2.
• Sedation was the most commonly reported side effect of quetiapine augmentation 2.

Non-Pharmacological Interventions

• Exposure and response prevention (ERP) is a gold-standard treatment for OCD and may be effective for postpartum OCD 3.
• A case report found that dual stimulation with intermittent theta-burst stimulation (iTBS) and continuous theta-burst stimulation (cTBS) improved obsessive-compulsive symptoms, anxiety, and depression in a postpartum OCD patient who refused medication and psychotherapy 4.

Gaps in Current Research

• There are no randomized, placebo-controlled drug trials in the acute or preventative treatment of postpartum OCD 1.
• Further studies are needed to establish the efficacy of pharmacotherapy and non-pharmacological interventions for postpartum OCD 4, 3, 1.