After initial psychological treatment patients with Obsessive Compulsive Disorder are treated with selective serotonin re-uptake inhibitors (SSRIs). Treatment may later be augmented with clomipramine and/or an antipsychotic. This study focuses on the biological treatment received after, or in parallel to, the psychological.

To collate and evaluate the levels of biological treatment currently received by OCD outpatients in the Bedford east catchment of Bedfordshire and Luton mental health and social care partnership NHS trust.

In particular we wished to establish how many of the patients were receiving an atypical antipsychotic as well as maximal SSRIs.

An anonymised database of 45 outpatients with symptoms of OCD was prepared. Treatment groups were identified and the percentage of the cohort occupied by these groups was calculated. The possibilities for increased medication were noted.

Only 7% of patients had one SSRI, at maximum dose, plus clomipramine, plus an antipsychotic, even here the dosing was not maximal. Another 7% had a second SSRI instead of the tricyclic and may benefit from a trial of clomipramine. In the remaining 86% there was further scope for increasing biological therapy.

Relatively few of our patients were having maximal SSRI treatment and an antipsychotic, despite guideline recommendations.

There is plenty of leeway for the escalation of patients’ biological therapy. Given the number of patients currently receiving secondary care, an escalation of their treatment should result in better patient health and a subsequent increase in discharges.