Obsessive-compulsive disorder (OCD) is often treated with drugs that are ineffective and unsafe. Natural treatments, from saffron and milk thistle to B vitamins and electroacupuncture, have shown promise for improving symptoms

Obsessive-compulsive disorder (OCD) is characterized by compulsive actions that follow upon intrusive, stressful thoughts. It is often treated with SSRI antidepressants. But the SSRIs are ineffective for 40% to 60% of people, and they have considerable and serious side effects. So, OCD is in need of better, safer treatments.

Many people suffering from OCD can't tolerate the side effects of the drugs, don't respond to the drugs or respond to the drugs at first but stop responding after a while. At least two herbs have gone head-to-head with the antidepressants.

Saffron and Ashwagandha for OCD

Saffron is an effective natural antidepressant, so a 10-week double-blind study compared 30 milligrams (mg) a day of saffron to 100 mg a day of fluvoxamine in 46 people with mild to moderate OCD. OCD scores went down slightly more in the saffron group, and though the difference was not significant, it suggests that saffron is at least as effective as the drug.

Another double-blind study gave 35 people with OCD either 10 mg of Prozac or 200 mg of milk thistle extract three times a day for eight weeks. Both the drug and the herb produced a significant benefit, and there was no significant difference between them: on the Yale-Brown Scale for OCD, milk thistle dropped the score by 11 points and Prozac by 12.5.

Ashwagandha has been proven to be effective for stress and anxiety, so researchers tried adding the herb to SSRI antidepressants. Thirty people with OCD added a placebo or 120 mg of ashwagandha root extract to their SSRI four times a day for six weeks. While scores on the Yale-Brown Obsessive-Compulsive Scale went down from 18 to 16 in the placebo group, they went from 26 to 14 in the herb group; a significantly better improvement.

NAC and Valerian Show Promise for Relieving Symptoms

Glutamine dysfunction may be a contributor to the development of OCD. N-acetylcysteine (NAC) supplementation is an effective way of increasing glutamine. When 48 people with OCD who had not responded to SSRIs added either a placebo or up to 2,400 mg of NAC a day for 12 weeks, people on NAC improved significantly on the Yale-Brown Obsessive-Compulsive Scale.

Overall, 52.6% of them were full responders (greater than 35% improvement) versus only 15% of the placebo group. A second small double-blind study of 11 children on medication added a placebo or up to 2,700 mg a day of NAC for 12 weeks.

The NAC significantly reduced scores on the Children's Yale-Brown Obsessive-Compulsive Scale: scores dropped from 21.4 to 14.4 on NAC but didn't improve at all on placebo. One out of 5 kids on NAC improved by more than 35%; none of the placebo kids did.

When 13 people with OCD were given a placebo or 18 grams (g) of inositol a day for six weeks in a double-blind study, the ones given the inositol had significantly greater improvement on the Yale-Brown Obsessive Compulsive Scale.

Valerian is a great relaxing herb. An eight-week double-blind study of 31 adults with OCD found that 765 mg a day of valerian extract helped obsessive and compulsive symptoms significantly more than placebo.

Immune Modulators and Anti-Inflammatories May Help

People with OCD have significantly lower levels of folic acid and higher levels of homocysteine, suggesting that supplementing folic acid might help. A study of children and adolescents with OCD did not find lower levels of folic acid, but did find lower levels of B12 and higher levels of homocysteine.

And a third study, which compared 35 people with OCD to 22 people without, again found low levels of B12 and elevated levels of homocysteine. Homocysteine levels correlated with Yale-Brown compulsion and Yale-Brown total scores. Folic acid, B12 and B6 are all involved in regulating homocysteine. These studies combined suggest that a deficiency of one of these B vitamins could contribute to elevated homocysteine that then contributes to OCD.

Studies of OCD in children have also found low levels of vitamin D. One study has suggested that deficiency in the amino acid arginine may also play a role in OCD.

Very recent research is suggesting that inflammation in the neurocircuitry, possibly as a result of an autoimmune response to infection, may play a role in OCD. That suggests that immune modulators and anti-inflammatories might help. And in a pilot study of 19 people whose OCD was resistant to therapy, adding electroacupuncture to their meds significantly improved treatment.

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