Obsessive-compulsive disorder (OCD) is a type of anxiety disorder that involves reoccurring obsessive thoughts and compulsive behaviors performed in response to these thoughts. OCD can be quite an inhibiting disorder for many people, making it incredibly difficult for them to go about their daily life. OCD is typically treated with cognitive-behavioral therapy and medication, and often people find that a combination of the two approaches is the most effective.

Antidepressants are usually the first type of medication used to treat obsessive-compulsive disorder. The Food and Drug Administration has approved clomipramine (Anafranil), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil, Pexeva), and sertraline (Zoloft) to treat OCD.

Clomipramine (Anafranil) is a type of medication known as a tricyclic antidepressant. It has been approved by the FDA to treat obsessive-compulsive disorder in adults and children ages 10 and older. Tricyclic antidepressants can be very effective, but they may cause more side effects than other types of antidepressants and are generally not the first recommended treatment.

Fluoxetine (Prozac) is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI), which works by increasing the level of serotonin in the brain. Fluoxetine has been approved to treat OCD in adults and children ages 7 and older.

Prozac comes in capsule and delayed-release capsule form. It’s worth noting that no individual SSRI was found to be more efficacious than other SSRIs for OCD. And in head-to-head studies between clomipramine and other SSRIs (fluvoxamine, paroxetine, sertraline), neither was shown to be a superior OCD treatment. (Note: SSRIs are often tried first as they are better tolerated by most people..)

Fluvoxamine (Luvox) is also an SSRI antidepressant and has been approved by the FDA to treat OCD in adults and children ages 8 and over. Fluvoxamine comes in tablet and extended-release capsule form.

Paroxetine (Paxil) is another SSRI class antidepressant that has been approved by the FDA to treat OCD in adults only. The medication comes in tablet and suspension (liquid) form.

Sertraline (Zoloft) is another SSRI antidepressant that has been approved by the FDA to treat OCD in adults and children ages 6 and older. The medication comes in tablet and oral solution (liquid) form.

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Off-Label Medications for OCD

Your physician or psychiatrist may also prescribe medication “off-label” to treat OCD, meaning the medication has proven effective in treating symptoms but has not been approved by the FDA for that specific purpose or age group. Citalopram (Celexa) and Escitalopram (Lexapro) are two additional selective serotonin reuptake inhibitor (SSRI) medications that are sometimes prescribed off-label to treat obsessive-compulsive disorder. Venlafaxine (Effexor) and Duloxetine (Cymbalta) are two antidepressants known as serotonin-norepinephrine reuptake inhibitors (SNRIs) that are also sometimes prescribed to treat OCD.

Evidence is limited for SNRIs—just one small study—an 8-week trial that randomly assigned 30  patents with OCD to either venlafaxine or a placebo. No significant difference in OCD symptom reduction between both groups was found 1

Sometimes people with OCD will also be prescribed a type of medication known as benzodiazepines. Benzodiazepines are fast at anxiety but are not considered a particularly effective treatment for obsessive-compulsive disorder. Patients can develop a tolerance to the drugs and in some cases become addicted. People who discontinue use of benzodiazepines may also experience powerful withdrawal symptoms. Sometimes these medications are prescribed with SSRIs until the SSRI reaches its full effect. For most people, benzodiazepines are not meant to be taken for the long-term.

OCD Medication Administration and Side Effects

When your doctor prescribes you medication to treat your OCD, you’ll want to make sure that you take the medication exactly as prescribed. If you’re taking an antidepressant class of medication, be aware that it may take several weeks to several months for your medication to achieve its full effect. Let your doctor know if you have any side effects, and do not abruptly stop using the medication without guidance from your doctor, as there can be withdrawal symptoms.

Common side effects of SSRIs used to treat obsessive-compulsive disorder can include:

  • drowsiness
  • dry mouth
  • insomnia
  • nervousness
  • nausea
  • diarrhea
  • dizziness
  • headaches
  • reduced sexual desire
  • erectile dysfunction
  • blurred vision

Most of the time, side effects will dissipate after a few weeks of taking the medication. If they persist, your doctor may consider prescribing you a different type of medication. Regardless, it’s important to track of side effects to inform your doctor and seek emergency care if necessary. Also, be sure to inform your doctor of any other medications you take, any medical conditions you have, and whether you are pregnant or planning to become pregnant before taking any OCD medication.

Antidepressant medications used to treat OCD are considered safe, but there have been cases where children, adolescents, and young adults have experienced an increase in suicidal thoughts and behaviors when taking antidepressants. If you or your child begin taking antidepressants, be sure to monitor for signs of suicidal thoughts and behavior while taking the medication—seek counsel about warning signs from your healthcare provider.

If you decide to stop OCD medication treatment under the guidance of your doctor, your doctor will probably want to slowly and safely decrease the amount of medication you are taking over time. You may still experience some withdrawal symptoms, which can include nausea, dizziness, fatigue, and other flu-like symptoms.

OCD Medication and Pregnancy

If you have been diagnosed with obsessive-compulsive disorder and are pregnant or planning to become pregnant, talk to your doctor about the risks and benefits of taking medication. Some SSRI medications such as fluoxetine and sertraline are prescribed during pregnancy. There is an increased risk of complications such as postpartum hemorrhage, low birth weight, and premature birth, but the risk remains low. There is an increased risk of fetal heart effect when taking the medication paroxetine. However, there are also potential risks of untreated obsessive-compulsive disorder when pregnant for both you and your child, so be sure to talk to your doctor about the potential risk and benefits of continuing medication treatment while pregnant.

If you think that you might have obsessive-compulsive disorder and could benefit from medication therapy, don’t hesitate to make an appointment with your doctor or psychiatrist today. Above all, it’s important to not be discouraged while you and your doctor find the right medication to treat your symptoms, as it make take several tries. Your doctor may also recommend that you pursue psychotherapy while taking medication in order to build additional coping skills for managing the symptoms of OCD. With the right tools and team of support, your OCD can become manageable and you can live a freer and fuller life.

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Last Updated: Oct 8, 2020