As mentioned previously, SSRIs have been associated with various dose-dependent side effects, including nausea, diarrhoea, dizziness, headaches, insomnia, sedation, anxiety, sexual dysfunction, and decreased libido [802]. As the dose required for a clinically significant improvement in OCD symptoms is typically higher than is required in the treatment of depressive disorders, the potential for unwanted side effects is substantially increased [803]. As such, several studies have examined alternative therapies in the treatment of single disorder OCD.
In a systematic review of these approaches, there was some evidence that mindfulness meditation, electroacupuncture, yoga, nutrient glycine, borage, and milk thistle may have a positive impact on OCD symptoms [804]. However, it is important to note that a number of these studies used methodologically weak designs, and none examined use of these therapies among people with comorbid OCD and AOD use.