(D) Systematic desensitisation # SSRIs are drug of choice. Fluoxetine, fluvoxamine, paroxetine, sertraline have been approved for OCD# Antidepressants: Some patients may improve dramatically with specific serotonin reuptake inhibitors (SSRIs). Clomipramine (75-300 mg/day), a non specific serotonin reuptake inhibitor (SRI), is the first drug used effectively in the treatment of OCD. The response is better in presence of depression, but many patients with pure OCD also improve substantially. Fluoxetine (20-80 mg/day) is a good alternative to clomipramine. Fluvoxamine (50-200 mg/day) is marketed as a specific anti-obsessional drug, while paroxetine (20-40 mg/day), and sertraline (50-200 mg/day) are also effective in some patients.> Antipsychotics: These are occasionally used in low doses (e.g. haloperidol, risperidone, olanzapine, pimozide) in the treatment of severe, disabling anxiety.> Buspirone has also been used beneficially as an adjunct for augmentation in some patients.# Second line drugs include> Valproate, lithium, or carbamazepine, venlafaxine, pindolol, & MAO inhibitors esp phenelzine, buspirone, 5 -hydroxy tryptamine (5-HT), L- tryptophan, & clonazepam.MANAGEMENT OF OCDBehavior therapyPharmacotherapyIs treatment of choiceSSRIs are drug of choice. Fluoxetine, fluvoxamine, paroxetine, sertraline have been approved for OCDIncludes: Exposure and response prevention, desensitization, thought stopping, flooding implosion therapy and aversion conditioning.Clomipramine: of all the tricyclic and tetracyclic drugs, clomipramine is the most selective for serotonin reuptake exceeded in this respect only by SSRI> People with OCD who fear dirt and germs are encouraged to get their hands dirty and wait increasing amounts of time before washing them.> The therapist helps the person cope with the anxiety that waiting produces; after the exercise has been repeated a number of times, the anxiety diminishes.> Systematic desensitization techniques involve gradually exposing the client to ever-increasing anxiety-provoking stimuli.> It is important to note here, though, that such a technique should not be attempted until the client has successfully learned re- laxation skills and can demonstrate their use to the therapist.> Exposing a patient to either of these techniques without increased coping skills can result in relapse and possible harm to the client