Obsessive Compulsive Disorder Information - OCD - vitamins, herbs and supplements, natural treatment by Ray Sahelian, M.D.
Feb 13 2014

Obsessive compulsive disorder OCD is classified as an anxiety disorder. There are some who think that there are several psychiatric and psychological conditions that are related. The notion of a spectrum of obsessive-compulsive related disorders that is comprised of such disparate disorders as obsessive compulsive personality disorder, body dysmorphic disorder, certain eating disorders such as bulimia and anorexia nervosa, pathological gambling, and autism, is gaining acceptance within the psychiatric community. The fact that these disorders share obsessive-compulsive features and evidence similarities in patient characteristics, course, comorbidity, neurobiology, and treatment response raises the question of whether obsessive compulsive disorders are best thought of as an anxiety or an obsessive compulsive spectrum disorder.

Some patients with obsessive-OCD often have other psychiatric disorders, such as depression, bipolar disorder, psychotic disorders, and eating disorders, which present challenges to the treating physician.

Natural treatment of Obsessive Compulsive Disorder
Standard treatments for OCD include selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavior therapy. There is little research regarding the natural treatment of obsessive compulsive disorder. However, since SSRIs have been found to be helpful in some patients, it is interesting to wonder whether 5-HTP, the serotonin precursor, may also have some benefit. I personally have not used 5-HTP for obsessive compulsive disorder in my practice, but I do have experience using this supplement for anxiety. The adult dose is normally 50 mg once or twice a day, and half or a third for a child. Other interesting options could be kava and inositol. Kava should not be used all the time, but perhaps every other day. Please discuss these natural treatment options with your doctor before using them.

5HTP or 5-hydroxy-tryptophan
I have personally not tried 5-HTP with patients who have OCD, however, since SSRIs seem to have an influence, it would be reasonable to assume that 5 HTP may also play a role.

Emails
I had read your article about 5-HTP and it's benefits and would like to add that yes, it really does help. I'm 42 yrs old and have had severe OCD my entire life. I started using 5-HTP about 6 months ago to replace the Luvox that I was taking. In combination with the 5-HTP, I take the max dosage of Anafranil, and it really does work well that way.

I have been on 100 mg of 5-htp for obsessive compulsive disorder and anxiety for about 10 days as well as inositol 8gm a day and 2 mg of xanax. I noticed the most obsessive compulsive disorder improvement when I started the 5-htp though the inositol helps.

Ashwagandha root extract
Withania somnifera, also known as ashwagandha, has been found to be helpful in a study done on rodents.

Passionflower
Taking passion flower herb it changed my life to the better. I used to have obsessive compulsive disorder and obsessive thoughts and with passion flower the thoughts are almost gone completely. I prefer using passion flower herb instead of those drugs in the market their side effects are much worse.
   Passion flower does help with relaxation.

Folate and folic acid, vitamin B12
Serum folate and homocysteine levels in patients with obsessive-compulsive disorder.
Psychiatry Clin Neurosci. 2005; Atmaca M, Tezcan E. University, School of Medicine, Department of Psychiatry, Elazig, Turkey.
Previous studies have shown that folate deficiency, increased homocysteine, impaired metylation have been identified in depressive disorder. Recently, growing research has resulted in the biological association between obsessive-compulsive disorder and affective disorders. Therefore, in the present study it was evaluated whether or not folate and homocysteine levels changed. We identified that a group of patients with OCD might have folate deficiency, higher homocysteine levels and probable impaired metylation and monoamine metabolism.

Recently I came across some documentation on excessive folic acid exacerbating OCD. Do you know of any link between the two?
   I am not aware of studies that show excessive intake of this B vitamin causes or aggravates this condition.

Vitamin B12 and folic acid serum levels in obsessive compulsive disorder.
Acta Psychiatr Scand. 1988.
Vitamin B12 and folate serum levels were studied in 30 patients with obsessive compulsive disorder and in two control groups comprised of 30 chronic schizophrenics and 30 normal healthy subjects. Six patients (20%) of the OCD group had abnormal low levels of vitamin B12. This prevalence was significantly higher than that of the control groups. No clinical neurological or haematological abnormalities accompanied the reduced vitamin B12 levels. Possible implication of this finding for the pathophysiology of OCD in a subgroup of patients and the possibility that the B12 deficiency could be the consequence rather than the cause of OCD are suggested.

Role of diet and food
Does diet play a role in obsessive compulsive disorder?
   I don't know. Diet does influence brain chemical levels, but I don't know if the course of obsessive compulsive disorder can be altered by food or diet. I doubt diet or food selection has a strong influence on OCD symptoms although some people may benefit from eating less sweets and sugar and more fish and omega-3 oils.

Obsessive compulsive disorder treatment
While both psychotherapy and medication can be effective for children and adolescents with obsessive-compulsive disorder, therapy may be the best choice. Such non-drug treatment, specifically a process involving exposure and response prevention (ERP), is not as widely available as medication, but it appears to be associated with fewer residual symptoms. ERP is more effective in the short term and it lasts longer than medication. ERP gives kids with OCD skills that no one can ever take away from them for life, whereas with medication they're relying on the pill. Cognitive-behavioral therapy involving exposure and response prevention (ERP) is the preferred treatment for children and adolescents, according to 1997 Expert Consensus Guidelines, but few therapists are trained in its use. Individuals treated with ERP are taught to face their fears by engaging in repeated and prolonged confrontation with whatever stimuli evokes their obsession, and refraining from responding with compulsive behavior. For example, those who frequently wash their hands after opening doors -- because of their fear of germs would practice touching doorknobs without washing their hands afterwards. Or, those with an irrational fear of bad luck associated with the number 13 may repeatedly be taken to the 13th floor of a building. When ERP therapy is unavailable, refused, or does not have the intended effect, SSRIs represent a viable treatment strategy.
   A significant body of evidence documented that the orbitofrontal cortex (OFC) and the head of caudate nucleus are involved in the mediation of obsessive-compulsive disorder (OCD) symptoms. Potent serotonin (5-HT) reuptake inhibitors (SSRIs) are the only antidepressant agents thus far shown to be effective in the treatment of OCD.

Medication for obsessive compulsive disorder - How to Treat
Medications most commonly used are the selective serotonin reuptake inhibitors (SSRIs) group of drugs such as fluoxetine. Prozac is the more widely available treatment for OCD. Patients may experience relapse upon discontinuation of their medication, however, so SSRI treatment is typically long-term. If you do use a SSRI for obsessive compulsive disorder, use the lowest effective dose.

Cause of obsessive compulsive disorder and symptoms
The cause of the condition is unknown. There is growing evidence that OCD represents abnormal functioning of brain circuitry, probably involving a part of the brain called the striatum. Some etiologic theories of OCD suggest a biological origin, including hypotheses involving the serotonergic system, the glutamatergic system, the orbital cortex and the basal ganglia, and streptococcal throat infections in children.
   OCD is characterized by recurrent, unwanted, and distressing thoughts (obsessions) and repetitive, irresistible, behaviors (compulsions). Individuals with OCD recognize that the obsessions and compulsions are senseless or excessive yet they are unable to stop these behaviors. Symptoms such as frequent hand washing and fear of germs or frequent checking (of locked doors, for example) and fear of mistakes or disasters can appear at any age, but are not usually recognized until around age 5. See below of a longer obsessive compulsive disorder symptom list.

Obsessive compulsive disorder in a child
This disorder affects about 1 percent of all children and adolescents and up to 3 percent of adults. When symptoms go untreated during the early years they usually persist throughout adulthood.
   There are many signs and symptoms that could indicate a child has obsessive compulsive disorder or a tendency towards such behavior. And parents should keep in mind that there degrees of OCD, from mild to severe. In certain cases, if the behavior is channeled towards something constructive, then everyone is for the better. Concern is aroused when the behavior is excessive and prevents the child from going on with activities of daily living. Look out for these signs and symptoms to determine whether your child has obsessive compulsive disorder: Is your child excessively concerned over germs or disease? Does he or she casue harm to self or others? Are there irrational fears? Does your child constantly worry about symmetry -- needs to have possessions / surroundings arranged symmetrically and/or to move in symmetrical ways, way beyond normal behavior? Actually certain OCD behaviors if not extreme can lead to future success at school or career. What about hoarding useless or meaningless objects such as old newspapers or food? Does your child have certain compulsions such as washing hands until they are red and chapped; brushing teeth until gums bleed. Checking -- returning to check that the door is locked more than once. Counting -- counting of steps while walking; insistence on performing a task a specific number of times. Repeating or redoing things over and over again?

Emails
Q. I read an article on obsessive compulsive anxiety disorder that said GABA was helpful. Have you heard of this?
     A. No, I have not come across research on GABA and obsessive compulsive disorder.

Is there a blood test for obsessive compulsive disorder?
   Not that I am aware of.

Q. I have started giving L tyrosine to my son ( adult- sized 17 year old) for obsessive compulsive disorder (he has mild OCD which was diagnosed when he was 5. It mainly manifests as slightly obsessive behavior which he is able to manage w/o medication. He is also a bit grumpy and depressive plus gets anxious when stressed. I started taking L Tyrosine myself recently ( for depression) and I found it to be very helpful so thought it might be good for my son to try for his grumpiness. He seems to be doing well on 500- 1000 mg plus a B vitamin supplement - a marked improvement!. I recently read about Inositol as a treatment for OCD and am considering it for him. I cannot find info anywhere regarding the interaction of inositol and tyrosene. Do you know if it is safe to combine them? I would like to give him 500- 100mg tyrosene combined with 500- 100 inositol (or possibly more if safe) From what I read, the studied dosage of Inositol for OCD is around
1.8 gm . I hope you will respond as I don't know where else to find this kind of info.
     A. We have not seen any research with this combination for obsessive compulsive disorder or other conditions, so it is difficult to predict. Over the long run, the use of 500 to 1000 mg of tyrosine may be too much for most people, particularly children. Under medical supervision one could try inositol by itself, starting with lower amounts, and once one has a good understanding on how inositol is working, then perhaps the combination could be tried with reduced dosages at first. Unexpected reactions can sometimes occur when nutrients or medicines are combined.

Q. I was wondering if you had any information as to what is the best possible herb (s) for obsessive compulsive disorder OCD patients. I have been reading different things on the internet and the two best ones I can come up with is St. John's Wort and Passion Flower.
   A. Perhaps St. John's wort could help in some people. 5HTP could also be tried, it may take trial and error to find the right supplement.

Q. I went on to your website to gain some knowledge on alternative remedies for obsessive compulsive disorder OCD. I found it extremely helpful and interesting and am emailing you to let you know how handy this was. I gave birth to my son via emergency caesarian on the 15th August 2006. It was a traumatic birth because I went through labour and then when that didn't work out, I had an emergency c section. Anyhow, after this, I was feeling low and down and because I couldn't breastfeed for long, it made me feel I wasn't a good mother. The worse was still to come. After approximately a month after he was born, I started developing intrusive thoughts about him. It began with the iron. I put him in front of me so i could see what I was doing, and then all of a sudden, I though "what if I put this to his face" God Forbid. This scared me and it made me wonder for days where this thought came from. I dont have any mental illness, never have, neither does it run in my family. So I was shocked when it came. These thoughts developed further and became more intense and scary. I saw knives close to his neck (in my mind of course) and this worried me lots. Everytime I would enter the kitchen, the 'knife' thought would pop into my head and it made me so panicky, that I would just break down in tears. This has been continuing for 8 months now. I decided to get some help so opted for homeopathy and vibrational therapy. They have helped me immensely but the thoughts are still there. They calmed my nerves and lessened the thoughts however, those thoughts are still lurking in the background, waiting to arise. It always is on my min, 'what shall I do', 'why did this happen to me', 'what can I do to solve it', these questions run in my head all day long even till this day. I have thoughts about harming him with sharp objects, basically anything my stupid mind wants to think, it comes up and the more I ignore it, the more it comes out. I also used to get thoughts about 'abuse' and the different types which put me in a great amount of mental anguish, because I could not accept my mind was thinking in such a horrid way. And it comes at the most oddest times of the day, whether I am shopping or watching TV, even if I am keeping myself occupied it still comes and it makes me shatter and weep, because I hate the thoughts, they disgust me and scare me. I would never act on them but its the fear of the thoughts coming. Its horrible, its sick and I want them to go away. I have steered clear from western medicine as I know the side effects of anti depressants so have chosen to go the alternative way. Today I bought Inositol, powder form, to see if this may help. I hope it does. Can u please suggest any tips for me. This is called post partum obsessive compulsive disorder. I have also taken up counseling - Cognitive Behavioural Therapy (CBT), which I am going to start next week some time, so hoping that plays a huge role in assisting me with this nasty condition I may have. What can I do to help me more? What else can I use to assist me? Would what I have be classified the same as ordinary OCD obsessive compulsive disorder? I would be very grateful for ur help, I have searched everywhere to find an answer. I love my son and just wish the bond between us could get strong. 8 months of his and my life have been disturbed emotionally with this upheaval.
   A. This is scary yet quite interesting how it developed post partum. We don't have any experience in the treatment of post partum obsessive compulsive disorder but it is worthwhile, under medical care, to try different supplements as listed on our page, and if they are not effective then the temporary use of medications could be tried.

Q. I had post partum obsessive compulsive disorder. I had this happen to me after my child was born. The thoughts are very scary indeed. However, I found out that my thyroid glad TSH was a 10 at that time! after they found out that my thyroid was causing my brain to malfunction and they set me on the road to fixing the thyroid. I am on Armour thyroid, it works very well for me and I recommend it to anyone. It took awhile to get back my normal mind and mental state, but, I am totally normal now with no obsessive compulsive disorder or bad thoughts! The thyroid and the mind connection is a huge factor and I thought maybe if someone reads this it would help them tremendously to know they are not crazy and to have the thyroid checked if you are having obsessive compulsive disorder symptoms or obsessive bad thoughts. It could very well be that is all it is, and when you can fix the thyroid the neurotransmitters start working again.

Q. In your article you state in the very beginning that obsessive compulsive disorder and obsessive compulsive personality disorder are one and the same. I would like to suggest that they are two very different disorders. While I am not a doctor, I have been diagnosed with obsessive compulsive personality disorder and in doing much research to learn about the disorder that I have struggled throughout my whole life, I know with little doubt that they are different disorders.
   A. Perhaps you did not read the first paragraph correctly. It says that they share similar characteristics, not that they are exactly the same disorder.

Q. I have read your articles on Sam-e and i am really impressed. I am suffering from Obsessive Compulsive Disorder since 18 yrs i initially took Prozac before and it helped me but side effects. I stopped taking it. Now i am ok but still suffering from OCD and a anxiety. I am working on computers as programmer i need to think logic a lot. I am scared to take any medication as it might make me not think or drowsy as i need to do job for my living. I want to try herbal supplements and am not sure which is good for obsessive compulsive disorder and little anxiety. i usually doest have courage to speak on stage or cant talk to boss with confidence) So can you please help me ,which is the best herbal medicine for my obsessive compulsive disorder problem with less side effects and should not obstruct my job.
   A. Some of the supplements listed above could be tried under medical supervision.

Q. i have been diagnosed with Obsessive Compulsive Disorder and tried Effexor and Celexa for about 1.5 months each and they both made me feel worse. Does 5htp help for ocd and anxiety? My GP tried to get me on Paxil and i said no thank you, I am afraid of these SSRI drugs.
   A. 5-HTP can help some people with obsessive compulsive disorder and anxiety but it is impossible to predict whether it will work in any individual person.

Q.  I  don't have any control on mind. My mind wants to remember the songs and will recollect without my permission. While at work I am not able to concentrate. If I listen to any song my mind recollects it and will stay in my mind forever. I am not able to concentrate. Please help me on this. If I require herbal medication then I am very much interested on it. Is this OCD?
   A. Good question. We have not studied this area of psychiatry and don't know if this falls under the category of obsessive compulsive disorder.

Q. I read something at the beginning of your OCD page that I wish to present a different opinion. In this line of an article regarding obsessive compulsive disorder, "Also known as obsessive compulsive personality disorder, obsessive compulsive disorder is classified as an anxiety disorder in the DSM-IV-TR [American Psychiatric Association, 2000. " For what I have read OCD and OCPD are different.
   A. The first line will now reads: Obsessive compulsive disorder OCD is classified as an anxiety disorder in the DSM-IV-TR [American Psychiatric Association, 2000. The latest thinking is that there is a large overlap between the two and some psychiatrists are starting to think that separating them into different categories may not be as necessary. OCPD could be considered within the obsessive compulsive spectrum and the treatment for these conditions has some similarities.

Q. I am a patient suffering from obsessive compulsive disorder. I used to take Prozac and it was working very well for the obsessive compulsive disorder but I noticed that I had no sex drive so my doctor has recently changed my medicine to Zoloft. I have been on Zoloft for almost a month now and has noticed a little change in my sex drive. I wonder if there is anything wrong taking Zoloft and ginseng? I was reading a lot about natural herbs and how they can improve sexual dysfunction. I was just wondering if mixing the two would be a bad idea.
   A. Depending on the dosage used of the medication and the supplements, side effects could occur. It is not easy to give a specific answer since different people may react differently regarding the combinations.

Which natural supplements are consider to be helpful in treating Obsessive compulsive disorder? If taken natural supplements for OCD, how long before results are noticed? Is there any studies none on natural supplements for treating OCD?
   Each person is different as to the effectiveness of the natural supplements for their condition and how long it takes to work.

Q. I thought I'd add a few comments to your obsessive compulsive disorder page. I'm a 55-year-old woman and have suffered from obsessive compulsive disorder since childhood. I'm now using a couple of diet and lifestyle changes that help me mitigate its effects. When I neglect one of these things I see more obsessive compulsive disorder symptoms within hours or days. What's beneficial to me in terms of a natural obsessive compulsive disorder treatment:
1) Eating a low glycemic index diet
2) Increasing omega threes in diet; cutting back on omega sixes. (I started doing this during menopause and it seemed to help with anxiety generally.)
3) Getting vigorous physical exercise -- by this I mean getting enough exercise to sweat through a T-shirt. I go to the gym a couple times a week.
4) Getting plenty of sleep. For reasons I don't understand my brain tends to reset itself overnight. Obsessive fears from the previous day tend to fade after a good night's sleep. If I get over-tired the OCD gets much worse.
Recently, I've also tried increasing my dietary magnesium intake. I cannot vouch for this with certainty, but I believe it helps. Thanks for the information on your site. I wish I'd had access to this much information decades ago!

Q. If someone suffers from a mild case of OCD, specifically obsessive thoughts is there something natural that may help alleviate this? Thanks for a great website and great information.

I have two different areas for which I am considering products. One is my son, who has been diagnosed only recently with OCD and my grandson who is ADHD. My grandson is currently taking B'Calmed. This seems to have helped and, perhaps over a period of time, this will prove to be sufficient to aid in this disorder. But, I was looking at some of the other products you have available and since dopamine and serotonin seems to be involved in ADHD, I was thinking that one of your products may be more effective. My grandson is 11 years old. I was looking at the Mind Power Rx, perhaps one a day. I noticed that you recommend only taking for 6 days and skipping a day. My son, who has been diagnosed with OCD, is now 41. He has been on medication, but it has had some bad reactions to the medications, and the doctor he went to put him on very high doses as opposed to starting out on smaller doses and increasing them over time. He is currently on two different medications. I do not recall the names of either, but I can get those if you need them. However, in reviewing information on your web site, I was thinking the L Tyrosine or 5HTP, together with the B Vitamin supplement may be helpful for him. I would appreciate any suggestion you could provide. I know that each person is different and may respond differently to supplements, but any information you could give would be appreciated.
    I am not in a position to provide individual suggestions, but perhaps some of the information on this page and the one on ADHD may be helpful.

I just finished reading your book Mind Boosters. It was so jam-packed with great info, Iíll need to read it over and over! I loved it. I was reading the book primarily to get nutritional supplement info for my daughter. The problem is sheís only 10 and Iím not sure if the recommendations in your book could carry over to the pediatric population. Therefore, Iím hoping you can recommend a supplement that would be safe for her. My daughter has many challenges. She was diagnosed with dyseidetic dyslexia about a year ago. She has a long history of worry and sensory problems and most recently has been diagnosed with ocd. She has had the ocd since June 2009. In appeared to come on overnight. We have ruled out P.A.N.D.A.s. She works with a cognitive behavioral therapist but is making little progress because of the severity of the ocd. We have tried SSRIs. First, Celexa which made her feel extremely restless and had to be in constant motion and secondly, Lexapro, which after 3 days, caused so much involuntary motor activity, that she ended up at the emergency room. She has been off of all prescriptions since August. She has tried SAM-e 200mg once a day and inositol 1600mg 3x/day along with co-enzyme B complex for a couple of months. There was initially a slight improvement in her condition, but that passed and we took her off of the Sam-e and inositol. Right now she is only on B complex and 1200mg of omega 3s. We avoid (as much as possible) any artificial food colorings / flavorings and preservatives. Trying to feed her a wholesome, balanced diet. Any suggestions on supplements we should try? She does not have any known allergies, but does have ďadverse reactionsĒ to Benedryl (makes her hallucinate and completely lose control).
   Perhaps some of the suggestions on this page could help. It is not easy to predict which therapy will work without giving a try. The dosages used in children are lower than those in adults.

I am hoping that you can share with me if you aware of any studies where nutritional supplementation has been helpful in treating young patients with mild - moderate OCD circumstances related to PANDAS. My daughter just turned 7 and within a week went from a kid that you had to force to take a bath, to a kid that washes her hands 30-40 times per day and wants to get in the shower the minute she gets home from school. Though our family doctor was not aware of the syndrome, I contacted a family therapist who we are scheduled to see early next week, who suggested it could be PANDAS. Her health history would certainly indicate that it is. She had a very high fever that lasted 5 days about a month ago and has had strep 4 times in the last 3 years. Our family doctor did prescribe a 10 day course of antibiotics which the case studies that we found recommended as a first course of treatment and we are hopeful that her symptoms will improve soon. That said, I am big believer in nutritional supplementation, and am wondering if there has been any studies that demonstrate an improvement in symptoms for OCD patients, even those where the condition is brought about as a result of PANDAS. I just bought some St. John's Wart liquid in hopes that would help with the anxiety.
    I am not familiar with the natural treatment of this condition.

I read some questions on your site about women, who after having given birth, develop post partum ocd and recalled something I heard from a naturopath, Vaughn Lawrence, who I believe stated that when a woman is pregnant, her body gets depleted of Omega 3 fatty acids because she has to transfer her stores to the baby for it's well-being, so when the baby's born the mother is has a serious deficiency of Omega 3s. Which is why, I believe, he recommends supplementing Omega 3s during pregnancies.