Natural remedies for OCD

The most common treatments for obsessive-compulsive disorder include cognitive behaviour therapy (CBT) or medication. This page discusses some natural remedies for OCD that have some support in clinical studies and/or have good theoretical backing. These natural remedies include inositol; 5-HTP; St John’s wort; N-acetylcysteine; omega-3.

N-Acetylcysteine (NAC) and Obsessive Compulsive Disorder

Current medications for obsessive-compulsive disorder affect the neurotransmitters serotonin or dopamine, however, increasing evidence suggests that hyperactivity in a neurotransmitter called glutamate may contribute to some cases of OCD.

N-Acetylcysteine (NAC) is an amino acid that effectively reduces the effects of glutamate in the brain. It is also used in the body to produce a potent antioxidant known as glutathione.

A few recent studies have discovered that NAC may be one of the helpful natural remedies for OCD. In one Australian study, it was shown that 3 patients with anxiety-based nail-biting were “cured” after the administration of NAC.

Another study(1) also showed that NAC helped patients with a disorder known as trichotillomania, (repetitive hair pulling that causes noticeable hair loss). Fifty adults with trichotillomania were randomly given a placebo or 1,200 to 2,400 mg daily of NAC for 12 weeks. The patients receiving NAC showed a significant reduction in hair pulling. 59% of the NAC users were “much or very much improved” as compared to 16% in the placebo group. Benefits began to appear after 9 weeks of treatment and produced no detectable adverse reactions. A published case study(2) also showed that the addition of NAC to conventional antidepressant medication improved OCD symptoms. When this person was treated with only antidepressants, treatment was ineffective. Only the combination of the two “medications” produced significant improvement in OCD symptoms.

Inositol and Obsessive Compulsive Disorder

Inositol is a nutrient that is part of the vitamin B family and is found in phytic acid, a component of fibre. When you consume phytic acid, the bacteria in your intestines release the inositol from the phytic acid. Inositol can naturally be found in nuts, seeds, whole grains and citrus fruits. Inositol is necessary for the proper formation of cell membranes and has the ability to affect nerve transmission; aid in the transportation of fats within the body; facilitate the action of various methylating agents; and play an important role in reproduction.

In one study(3), inositol was found to help relieve OCD symptoms. In this study, thirteen patients with obsessive-compulsive disorder were given 18g a day of inositol or placebo for 6 weeks. Compared to the placebo, when the patients were taking inositol, OCD symptoms improved. From this, the researchers concluded that inositol was effective in the treatment of OCD.

Inositol may be one of the effective natural remedies for OCD carrying having fewer side effects than antidepressant medication. I have actually found it to be helpful for some of my patients suffering from OCD (along with 5-HTP), however, at high doses, it can cause mild gastrointestinal disturbances.

St John’s Wort and Obsessive Compulsive Disorder

A study published in the journal of clinical psychiatry(4) evaluated the effectiveness of St John’s wort for the treatment of obsessive-compulsive disorder. Twelve subjects with OCD of at least 12 months’ duration were given 450mg of St John’s wort twice daily for 12 weeks. An evaluation of these patients showed that OCD symptom improvements began after week 1 of treatment and continued to improve. By the end of the 12 weeks, 5 (42%) of 12 people were rated “much” or “very much improved” and 6 (50%) were “minimally improved,” while 1 (8%) had “no change.” The most common side effects reported were diarrhoea (N = 3) and restless sleep (N = 2). The researchers concluded that St John’s wort was an effective natural remedy for OCD.

However, another more recent study(5) found St John’s Wort to be ineffective in treating OCD. Sixty subjects diagnosed with OCD were randomly allocated to either receive St John’s wort or placebo for 12 weeks. After 12 weeks, there was an improvement in OCD symptoms for both groups, with 17.9% of people on St John’s wort and 16.7% of people on placebo reporting to be ‘much’ or ‘very much’ improved. While both treatment groups experienced improvement there was no significant difference between the two groups. The researchers concluded that St John’s wort was not effective for OCD although they felt that further research in the area was required before firm conclusions about St John’s Wort and OCD could be made.

I have not used St John’s wort for the treatment of OCD with my clients, so have no clinical experience into its effectiveness. While, theoretically St John’s wort could be helpful for many people with OCD, further research is required.

5 HTP and Obsessive Compulsive Disorder

Tryptophan and 5 HTP (5-hydroxytryptophan) are amino acids necessary for the production of serotonin. Because it has been shown that serotonin-promoting tricyclic antidepressants and SSRIs are successful in treating OCD, tryptophan and 5 HTP may also be effective treatment options for OCD.

Unfortunately, despite the theoretical possibility that tryptophan and 5-HTP may be effective in treating OCD research into their effectiveness are lacking. In my clinical experience, I have found 5 HTP in many cases to be one of the helpful and effective natural remedies for OCD. This observation is also supported by many natural/ nutritional practitioners in mental health.

Fish Oil / Omega 3 and Obsessive Compulsive Disorder

People suffering from mental disorders such as depression and anxiety related disorders like OCD have been found to have deficiencies in omega 3 fatty acids, indicating that a fatty acid deficiency could possibly play a significant role in their mental health.

Studies in the OCD area are severely lacking, although one small study(6) did find that supplementation with eicosapentaenoic acid (EPA) (a type of omega 3) did not have any beneficial effect on OCD symptoms after 6 weeks. However, given the growing mountain of evidence that fish oil improves mental functioning, mood, concentration, and stress levels, fish oil / omega 3 supplements certainly will do no harm.  It has been effective in alleviating not only the symptoms of depression and bipolar disorder but a whole host of other conditions including schizophrenia, ADHD, PMS, post-natal depression and many other mood and anxiety related conditions.  Because of its numerous mental and physical benefits, fish oil could be a good option for people with OCD, but is unlikely to be a cure on its own.

References

1. Grant J, et al (2009) N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania. Arch Gen Psych, 66, 756-63.
2. Lafleur DL, et al. (2006) N-acetylcysteine augmentation in serotonin reuptake inhibitor refractory obsessive-compulsive disorder. Psychopharmacology. 184, 254-256.
3. Fux, M., Levine, J., Aviv, A., and Belmaker, R.H. (1996). Inositol treatment of obsessive-compulsive disorder, Am J Psychiatry, 153, 1219-1221.
4. Taylor, L.H., & Kobak, K.A. (2000) An open-label trial of St. John’s Wort (Hypericum perforatum) in obsessive-compulsive disorder, J Clin Psychiatry, 61(8), 575-8
5. Kobak KA, Taylor LV, Bystritsky A, Kohlenberg CJ, Greist JH, Tucker P, Warner G, Futterer R, Vapnik T. (2005) St John’s wort versus placebo in obsessive-compulsive disorder: results from a double-blind study. International Clinical Psychopharmacology, 20:299-304
6. Fux, M. Benjamin, J., & Nemets, B. (2004) A placebo-controlled cross-over trial of adjunctive EPA in OCD. J Psychiatr Res, 38(3):323-5.