<prompt> The following modes of therapy may be useful for treatment of Obsessive Compulsive Disorder EXCEPTFluoxetineClomipramineBehaviour therapyElectroconvulsive therapy  <response>: D Electroconvulsive therapy Treatment of OCD: Psychotherapy: Psychoanalytic-Psychotherapy is used in certain selected patients, who are psychologically oriented. Supportive psychotherapy is an important adjunct to other modes of treatment. Supportive psychotherapy is also needed by the family members. Behaviour Therapy Cognitive Behaviour Therapy: Behaviour modification is an effective mode of therapy, with a success rate as high as 80, especially for the compulsive acts. It is customary these days to combine CBT with BT at most centres. Thought-stopping and its modifications. Response prevention. Systematic desensitisation. Modelling Drug Treatment: Benzodiazepines E.g. Alprazolam, Clonazepam have a limited role in controlling anxiety as adjuncts and should be used very sparingly. Antidepressants: Some patients may improve dramatically with specific serotonin reuptake inhibitors SSRIs. Clomipramine 75-300 mgday, a non-specific serotonin re-uptake inhibitor SRI, was the first drug used effectively in the treatment of OCD. The response is better in the presence of depressive symptoms, but many patients with pure OCD also improve substantially. Fluoxetine 20-80 mgday is a good alternative to clomipramine and often preferred these days for its better side-effect proule. Fluvoxamine 50-200 mgday is marketed as a specific anti-obsessional SSRI drug, whilst Paroxetine 20-40 mgday Sertraline 50-200 mgday are also effective in some patients. Antipsychotics: These are occasionally used in low doses e.g. haloperidol, risperidone, olanzapine, aripiprazole, pimozide in the treatment of severe, disabling anxiety. Buspirone has also been used beneficially as an adjunct for augmentation of SSRIs, in some patients. Electroconvulsive Therapy: In presence of severe depression with OCD, ECT may be needed. ECT is particularly indicated when there is a risk of suicide andor when there is a poor response to the other modes of treatment. ECT is not the treatment of First choice in OCD. Psychosurgery: Psychosurgery can be used in treatment of OCD that has become intractable is not responding to other methods of treatment. It is worth mentioning that psychosurgery is only available as a treatment choice at a very few centres throughout the world. The best responders are usually those who have significant associated depression, although pure obsessives also do respond. The main benefit is the marked reduction in associated distress and severe anxiety. 