Medications for Obsessive-Compulsive Disorder (OCD)

This article can give you a general idea about each of the medicines listed below. Only the most general side effects are listed. Ask your doctor if you need to take any special precautions. Use medicine as recommended by your doctor. If you have questions about use or side effects, contact your doctor.

Your doctor may give you medicine to ease unwanted thoughts and habits. They may be called anti-obsessional medicine. They can also help you feel less anxious and afraid. It may take a few weeks before you start to see an improvement

Most medicine used to treat OCD are antidepressants. They can treat brain hormones that are out of balance. If you have depression with OCD or due to OCD, antidepressants can help with this as well.

Prescription Medications

Selective Serotonin Reuptake Inhibitors (SSRIs)

  • Citalopram
  • Escitalopram
  • Fluoxetine
  • Fluvoxamine
  • Paroxetine
  • Sertraline

Tricyclic Antidepressants

  • Clomipramine

Atypical Antidepressants

  • Trazodone
  • Venlafaxine
  • Vilazodone

SSRIs

Common names include:

  • Citalopram
  • Escitalopram
  • Fluoxetine
  • Fluvoxamine
  • Paroxetine
  • Sertraline

SSRIs work on a chemical in the brain called serotonin. It plays a role in anxiety, depression, and OCD. High doses of SSRIs may be needed. Improvements may appear in 4 to 6 weeks. SSRIs are not addictive. Do not take an SSRI if you have taken a monoamine oxidase inhibitor (MAOI) in the last 2 to 5 weeks.

Possible side effects include:

  • Nausea
  • Diarrhea
  • Insomnia
  • Loss of appetite or weight loss
  • Weight gain
  • Lightheadedness
  • Sexual dysfunction (such as decreased arousal, erectile dysfunction, delayed time to orgasm)
  • Nervousness
  • Risk of severe mood and behavior changes, including suicidal thoughts in some patients (young adults may be at a higher risk for this side effect)

Tricyclic Antidepressants

Common name: Clomipramine

Tricyclic antidepressants effect serotonin and/or chemical called noradrenalin in the brain. They have been effective for the treatment of OCD. Improvement is usually seen in 2 to 6 weeks. Tricyclic antidepressants are not addictive.

Possible side effects include:

  • Lightheadedness
  • Sleepiness
  • Dry mouth
  • Constipation
  • Difficulty urinating
  • Weight gain
  • Low blood pressure
  • Sexual dysfunction
  • Risk of severe mood and behavior changes, including suicidal thoughts in some patients (young adults may be at a higher risk for this side effect)

Atypical Antidepressants

Common names include:

  • Trazodone
  • Venlafaxine
  • Vilazodone

Atypical antidepressants affect serotonin levels. It can be effective in treating OCD. Improvement is usually seen in 4 to 6 weeks.

Possible side effects include:

  • Nausea
  • Nervousness
  • Diminished sex drive
  • Risk of severe mood and behavior changes, including suicidal thoughts in some patients (young adults may be at a higher risk for this side effect)

Special Considerations

Medicine should provide some benefit for most. A specially trained mental health expert should be seen if medicine it not helpful. The expert can help find out if another mental health issue is causing problems. They can help to make a better plan.

If you are taking medicine, follow these general guidelines:

  • Take the medicine as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medicine with anyone.
  • Medicines can be dangerous when mixed. Talk to your doctor if you are taking more than 1 medicine, including over the counter products and supplements.

References:

About OCD. International OCD Foundation website. Available at: https://iocdf.org/about-ocd. Accessed January 13, 2020.
Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at:
...(Click grey area to select URL)
Accessed January 13, 2020.
Obsessive-Compulsive Disorder (OCD). EBSCO DynaMed website. Available at: https://www.dyname.... Accessed January 13, 2020.
Obsessive-compulsive disorder (OCD). National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml. Accessed January 13, 2020.
2/18/2011 DynaMed Systematic Literature Surveillance https://www.dyname...: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.
Last reviewed May 2020 by Adrian Preda, MD
Last Updated: 7/29/2020

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