Several treatment options may target reward mechanisms in OCD (Table 3). First, patients on SSRIs have been found to perform better on reward-learning tasks than patients off-SSRIs [156], indicating that these medications may be beneficial for improving reward-related alterations in OCD. This is consistent with increasing recognition of the importance of serotonin signaling in reward function [157]. Dopamine-acting drugs such as methylphenidate (Table 3) are effective in normalizing atypical reward-related performance and neural activity in ADHD [158] and may be an effective augmentative strategy for some OCD treatment resistant patients [155]. A recent study similarly reported altered neural activity in the reward-circuit during a reward-learning task in OCD following acute administrations of the dopamine-regulating drugs pramipexole and amisulpride [155].
