Two first-line treatments, not one
Exposure and response prevention (ERP) — a specific form of CBT — and SSRI medication are both established first-line treatments for OCD. Delivered by experienced practitioners, ERP may be the most effective single treatment available. Neither is a lesser option; the choice turns on severity, preference, access, and what else is going on.
OCD medication runs on different settings
SSRIs in OCD typically need higher doses and longer trials than in depression — often 8 to 12 weeks at the highest comfortable dose before judging whether it worked. Between 40% and 65% of people respond. Judging a medication too early, at too low a dose, is one of the most common ways OCD care goes wrong.
When combining helps most
Adding medication to ERP earns its keep most clearly when symptoms are severe or depression co-occurs. And sequence can be strategic: when exposure work feels impossible, starting medication first can reduce symptoms enough to make ERP doable.
Stopping medication, carefully
A landmark 2022 randomized trial found that many people who reach wellness after ERP can taper their medication and maintain their gains — but the taper group saw more clinical worsening, which is why discontinuation is a monitored, planned process, not a cliff. Foundry manages the medication side and coordinates closely with ERP-trained therapists; that coordination is the actual standard of care.
Safety and scope
This guide is general education, not medical advice. It does not create a treatment relationship, diagnose a condition, promise medication, or replace crisis care. For immediate danger use 911, 988, or the nearest emergency department.
Related service
Medication management
Medication management is guided by evidence, safety, treatment response, tolerability, medical history, medication interactions, and patient preference.