Recent Advances in the Treatment of OCD

This review synthesizes recent advances in the management of obsessive-compulsive disorder (OCD), a chronic and disabling psychiatric condition in which 40–60% of patients remain symptomatic despite first-line treatments such as selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioural therapy with exposure and response prevention (ERP). Innovations in psychotherapy include inhibitory learning–based ERP, the Bergen 4-Day Treatment, intensive inpatient CBT, digital and virtual reality–delivered ERP, AI-assisted interventions, and adjunctive modalities such as metacognitive therapy, acceptance and commitment therapy, and danger ideation reduction therapy. Pharmacological progress has been slower, though high-dose SSRIs, venlafaxine, antipsychotic augmentation, glutamatergic modulators, cannabinoids, ketamine, psychedelics, and other investigational agents show promise for treatment-resistant cases. Neuromodulation techniques—particularly deep transcranial magnetic stimulation, accelerated TMS protocols, transcranial direct and alternating current stimulation, and drug-assisted TMS—offer non-invasive augmentation options, while advances in psychosurgery, including refined gamma knife capsulotomy, deep brain stimulation, and emerging adaptive closed-loop DBS, provide hope for the most refractory patients. Future directions emphasize integrative, personalized, and technology-enhanced approaches, leveraging neuroimaging, computational psychiatry, and biomarker-driven treatment selection to improve outcomes in this complex disorder.