Medication management for obsessive-compulsive disorder by video, coordinated with the therapy that works best alongside it. Flat cash-pay pricing and no controlled substances.
Tyler Patten, APRN, PMHNP-BC — board-certified psychiatric nurse practitioner
Book Now →Obsessive-compulsive disorder is a cycle: an unwanted thought, image or urge shows up and causes intense distress, and you do something — checking, washing, counting, mentally reviewing, seeking reassurance — to make the distress go away. The relief is real but short, and every round makes the next one stronger. Many people with OCD hide it for years, because the thoughts feel shameful or frightening even though they run against everything the person values.
OCD is very treatable, but care that actually fits it is hard to find. Utah, Idaho and Nevada all have too few psychiatric prescribers, therapists trained in exposure and response prevention are even scarcer, and rural areas have the fewest of both. OCD is also frequently misread as general anxiety, which leads to medication doses and plans that never quite reach it.
Video visits remove the distance problem. We see adults anywhere in the three states, and we can help you find ERP therapy, including telehealth options, to pair with medication.
Fear of germs, illness or “contamination” that drives repeated cleaning or avoidance.
Rechecking locks, stoves or messages because the feeling of certainty never arrives.
Unwanted violent, sexual or taboo thoughts that cause intense distress, sometimes called “Pure O.”
Religious or moral worry that you’ve done something wrong, with repeated confessing or reassurance seeking.
Constant doubt about a partner or about illness that no amount of checking resolves.
Body-focused repetitive behaviors that often travel with OCD and anxiety.
OCD treatment works best when medication and exposure-based therapy go together, so I treat medication as one half of the plan, not the whole thing. I’ll help you find an ERP-trained therapist and adjust medication around how that work is going.
SSRIs are the first-line medications for OCD, and OCD often needs higher doses and a longer trial — eight to twelve weeks — than depression or anxiety do. When an SSRI isn’t enough, options include clomipramine or adding a second medication. I also look at the things that make OCD louder: poor sleep, high stress, caffeine and alcohol, and medical issues worth checking with lab work. For skin picking and hair pulling, we can talk about N-acetylcysteine, a supplement with some supporting evidence.
I don’t prescribe benzodiazepines or other controlled substances. They can blunt anxiety in the moment but tend to work against the exposure work that actually shrinks OCD.
You need to be physically located in one of these states during each video visit.
Many Utahns start an SSRI in primary care. OCD often needs a higher dose and a longer trial than that first prescription, so if a medication “didn’t work” for your OCD, it may never have reached an OCD dose.
With the fewest psychiatrists per person in the country, Idaho has very few OCD-informed prescribers outside Boise. We see adults anywhere in the state by video.
In the Las Vegas valley and Reno the usual barrier is a waitlist; in rural Nevada it’s distance. Either way, a video visit gets treatment started from home.
Further reading:
Book a 60-minute evaluation with Tyler Patten, PMHNP-BC. Most new patients are seen within two weeks.
Book Now →Questions first? Call or text (435) 625-3098 or email office@affordablepsych.org.