When do you consider adding an antipsychotic for SSRI-refractory OCD, and which agent do you typically choose first?  

There are so many factors that play into my decision-making; it truly is a case-by-case basis. In my opinion, the most common mistake is not adequately titrating the dose of the SSRI. You also need to make sure they are getting high-quality CBT/ERP at least 1x/week, ideally 2x/week for the first mo...

Thank you, Drs. @McDonald and @Glazer for sharing your thoughtful expertise.  The addition of "treatment resistant" to a question in this series routinely triggers at least one comment reminding us to ask, “What did I miss?" For treatment-resistant OCD, the question must recognize the p...