Medications for Obsessive-Compulsive Disorder (OCD)
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The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Your doctor may give you medicine to help alleviate your unwanted thoughts and repeated actions. These are often referred to as anti-obsessional medications. They can also help you feel less anxious and afraid. It may take a few weeks before you start to see an improvement

Most of the drugs used to treat obsessive-compulsive disorder (OCD) are antidepressants. These medications affect brain hormones that are out of balance. If you develop depression in association with OCD or because of the disability produced by OCD, antidepressants can help with this as well.

Prescription Medications
Selective Serotonin Reuptake Inhibitors (SSRIs)

  • Citalopram
  • Fluvoxamine
  • Paroxetine
  • Fluoxetine
  • Sertraline
  • Escitalopram
Tricyclic Antidepressants

  • Clomipramine
Atypical Antidepressants

  • Trazodone
  • Venlafaxine
  • Nefazodone
Selective Serotonin Reuptake Inhibitors (SSRIs)
Common names include:

  • Citalopram
  • Fluvoxamine
  • Paroxetine
  • Fluoxetine
  • Sertraline
  • Escitalopram
SSRIs affect the concentration of the neurotransmitter serotonin, which plays a role in anxiety , depression , and OCD. It appears that for most people, high doses of these drugs are required to produce anti-obsessional effects. Improvement is usually seen in 4-6 weeks after beginning treatment. SSRIs are not addictive. Do not take an SSRI if you have taken a monoamine oxidase inhibitor (MAOI) in the last 2-5 weeks.

Possible side effects include:

  • Nausea
  • Diarrhea
  • Insomnia
  • Loss of appetite or weight loss
  • Weight gain
  • Dizziness
  • Sexual dysfunction (ranging from decreased arousal, to erectile dysfunction , and/or 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 regulate the neurotransmitters serotonin and/or noradrenalin in the brain. They have been used effectively for the treatment of OCD. Improvement is usually seen in 2-6 weeks after beginning treatment. Tricyclic antidepressants are not addictive.

Possible side effects include:

  • Dizziness
  • 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
  • Nefazodone
Atypical antidepressants affect the concentration of the neurotransmitter serotonin and can be effective in treating OCD. Improvement is usually seen in 4-6 weeks after beginning treatment.

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
Consultation with a specially trained mental health professional is recommended if you do not respond to treatment with medications. A mental health professional can help clarify the diagnosis and determine if another psychiatric disorder is present. He can also make recommendations about psychotherapy and changes in medications.

Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed—Not more, not less, not at a different time.
  • Do not stop taking them without consulting your doctor.
  • Don’t share them with anyone else.
  • Know what effects and side effects to expect, and report them to your doctor.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don’t run out.



References:
About OCD. Obsessive-Compulsive Foundation website. Available at: http://www.ocfoundation.org/whatisocd.aspx . Accessed September 8, 2008.

Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273 . Published May 22, 2009. Accessed July 15, 2009.

Braunwald E. Harrison's Principles of Internal Medicine . 18th ed. New York, NY: McGraw-Hill; 2011.

Moore DP, Jefferson JW. Handbook of Medical Psychiatry . 2nd ed. Philadelphia, PA: Elsevier Mosby; 2004.

Obsessive-compulsive disorder (OCD). Anxiety Disorders Association of America website. Available at: http://www.adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/symptoms . Accessed September 8, 2008.

Stern, TA et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry . 1st ed. Philadelphia: Mosby Elsevier, 2008.

2/18/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.

Last Reviewed September 2013



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