The 8 Best Medications for OCD

WRITTEN BY MODERN RECOVERY EDITORIAL TEAM

NOVEMBER 10, 2022

The 8 Best Medications for OCD

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Obsessive-Compulsive Disorder (OCD) is a common mental health issue. The International OCD Foundation estimates that 1 in 100 adults in the United States have OCD. Around 1 in 200 teens and children have OCD.

While there is no cure for OCD, some types of therapy and medications can help people control their symptoms.

What is OCD?

Obsessive-Compulsive Disorder (ODC) is a chronic mental health disorder. A person with OCD can have intrusive reoccurring thoughts called obsessions. The thoughts are uncontrollable.

Common obsessive thoughts can be something like having things in perfect order or symmetry. It could be aggressive thoughts toward themselves or other people. Fear of germs or being contaminated is another common obsessive thought.

Obsessive thoughts are not limited to the suggestions above, it could be any repeated thought that brings on anxiety.

They may also have behaviors that they repeat over and over again. These are called compulsions. Often, compulsions are a person’s response to obsessive thoughts.

Common compulsive behaviors can be arranging items in a particular order or repeatedly checking that the door is locked. It could also be compulsive counting, handwashing, or cleaning.

People with OCD have significant problems in their daily lives because of obsessive thoughts and/or compulsive behaviors.

Who is Affected by OCD?

Men and women of any race or background can be affected by OCD. Symptoms usually appear between the ages of 8 and 12, or in the late teens to early adulthood. However, OCD symptoms can happen at any age.

What Causes OCD?

There is not a well-defined cause of OCD. There are three main theories for how OCD begins. The theories are:

  • Genetics – there could be a genetic predisposition for OCD. A specific gene has not yet been identified.
  • Biology – a change in the body’s chemistry or brain function could set off the symptoms of OCD.
  • Learned behavior – it is possible for obsessive fears and compulsive behavior to be learned over time by watching family members who have the behaviors.

There are some recognized risk factors for developing OCD. Going through a traumatic or stressful event can trigger symptoms of OCD. Childhood trauma or abuse may also be connected to OCD.

Having a family member with OCD increases a person’s chances of developing the disorder. It is possible that having another mental health disorder like depression or substance use can increase the possibility of having OCD.

How is OCD Diagnosed?

OCD can be difficult to diagnose, symptoms are similar to other disorders like anxiety. This is especially true for anyone who may already have another mental health disorder.

Not everyone who thinks obsessive thoughts or does certain behaviors has OCD. Symptoms are considered OCD when any of the following are true:

  • Spending at least one hour each day on the thoughts or behaviors.
  • Getting brief relief from anxiety after doing compulsive behaviors, but not getting pleasure from the behaviors.
  • Not being able to control thoughts or behaviors even when knowing they are excessive.
  • The thoughts and/or behaviors cause serious problems in everyday life.

What Medications Work Best for OCD?

No medication has been specifically created to treat OCD. Doctors often prescribe antidepressants to help treat OCD symptoms.

Serotonin Reuptake Inhibitors (SSRIs) work well to help control OCD symptoms. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are another type of antidepressant that can be helpful to people suffering from OCD symptoms.

The following antidepressants are FDA approved to treat OCD:

  • Anafranil (clomipramine)
  • Luvox (fluvoxamine)
  • Paxil (paroxetine)
  • Prozac (fluoxetine)
  • Zoloft (sertraline)

These antidepressants can be prescribed off-label to help with OCD symptoms:

  • Celexa (citalopram)
  • Effexor (venlafaxine)
  • Lexapro (escitalopram)

Off-label use means that an FDA-approved drug is used in a different way than it was intended. This can happen if a healthcare provider thinks the drug will be beneficial to the patient. For example, a situation where a patient has tried all the medications approved for their condition with no improvement.

Anafranil (clomipramine)

Anafranil is a tricyclic antidepressant. It works in a way similar to an SSRI by keeping the amount of serotonin in the brain at a higher level. This medicine has been shown to work well in treating OCD, but is not usually the first prescribed drug due to side effects.

Common side effects of Anafranil include:

  • Sweating
  • Changes in appetite or weight
  • Tremors, jerking muscle movement
  • Dizziness
  • Drowsiness
  • Feeling nervous
  • Urination problems
  • Vision changes
  • Decreased sex drive

There are more serious side effects possible. Anyone experiencing the following side effects should call their doctor right away:

  • Low sodium levels (headache, confusion, slurred speech, severe weakness)
  • Confusion, extreme fear
  • Thoughts of hurting oneself
  • Eye pain, blurred vision, tunnel vision
  • Pain or burning with urination
  • Seizure

Luvox (Fluvoxamine)

Luvox can be used to treat OCD symptoms in children over age 8 and adults. A study using the extended-release version of the medicine showed improvement over a twelve-week period.

The improvements were in overall mental health, emotions, and interactions with other people.

Luvox does have some common side effects:

  • Nervousness
  • Sleep disturbances
  • Headache
  • Nausea
  • Dry mouth
  • Weakness
  • Constipation

Some less common, but more serious side effects that could happen include:

  • Mood, behavior, or mental changes
  • Trouble breathing
  • Twitching
  • Problems urinating
  • Confusion
  • Inability to move the eyes
  • Seizures

If someone is having those side effects they should contact their doctor quickly.

Paxil (Paroxetine)

Paxil is an SSRI used to treat a variety of mental health issues. This includes OCD, depression, PTSD, anxiety, and panic disorder. It can be used by adults aged 18 and older.

It is important to know that people taking Paxil can develop angle-closure glaucoma. If someone taking Paxil has eye pain, changes in vision, swelling, or redness in or around the eye, they should get medical help right away.

Common side effects of Paxil include:

  • Headache
  • Sleepiness
  • Nausea
  • Vomiting
  • Gas
  • Stomach pain
  • Forgetfulness
  • Decreased appetite
  • Heartburn
  • Confusion
  • Dry mouth
  • Sweating
  • Yawning
  • Tenderness or swelling of joints

Some serious side effects are possible:

  • Hallucinating
  • Chest pain
  • Seizures
  • fainting

Prozac (Fluoxetine)

Prozac can be used to treat depression, eating disorders, panic disorder, bipolar disorder, and OCD. Prozac may improve symptoms like washing compulsions and obsessive thoughts. It has been approved for use in OCD patients aged 7 and older.

Common Prozac side effects include:

  • Dry mouth
  • Sweating
  • Headache
  • Insomnia
  • Strange dreams
  • Upset stomach
  • Sinus pain
  • Sore throat
  • Hot flashes

Serious side effects include:

  • Low sodium levels
  • Blurred vision, tunnel vision, eye pain
  • Pounding or fluttering heartbeat
  • Rigid muscles

Zoloft (Sertraline)

Zoloft can be taken by children aged 6 and up as well as adults for OCD treatment. Zoloft is also used to treat depression, social anxiety disorder, PTSD, and premenstrual dysphoric disorder. This medication is also sometimes used to treat headaches.

Zoloft is an SSRI. Some of the possible side effects of taking Zoloft include:

  • Loss of appetite
  • Problems falling asleep or staying asleep
  • Dry mouth
  • Heartburn
  • Nausea, vomiting
  • Dizziness
  • Nervousness
  • Excessive sweating

More serious side effects are possible with Zoloft, including:

  • Hives, rash
  • Difficulty breathing
  • Abnormal bleeding or bruising
  • Seizures
  • Hallucinations
  • Loss of coordination

Celexa (Citalopram)

Celexa is an SSRI used to treat depression. Celexa is not approved to be used by children.

People using Celexa to treat OCD take a higher dosage than those using it for depression. The higher dosage can increase the risk for heart-related side effects like heart palpitations.

Some common side effects of Celexa include:

  • Muscle or joint aches
  • Fatigue
  • Sweating
  • Hot flashes
  • Insomnia
  • Dysmenorrhea (painful menstrual periods)
  • Upper respiratory infections

More serious side effects include:

  • Suicidal thinking
  • Mania or hypomania
  • Low sodium levels
  • Bleeding
  • Seizures

Effexor (Venlafaxine)

Effexor is an SNRI used to treat major depressive disorder in adults. It can also be used to treat panic disorder, social anxiety disorder, and generalized anxiety disorder. Effexor may sometimes be used off-label to treat OCD.

Common side effects while using Effexor are:

  • Dry mouth
  • Yawning
  • Nausea
  • Increased sweating
  • Tremors
  • Fast heartbeat
  • Headache
  • Dizziness
  • Blurred vision

Serious side effects that are possible:

  • Low sodium levels
  • Unusual nosebleeds or bleeding gums
  • Seizure
  • Chest tightness
  • Trouble breathing
  • Severe nervous system reactions

Lexapro (Escitalopram)

Lexapro is an SSRI used to treat depression and generalized anxiety disorder. It can be used off-label to treat OCD.

Some common possible side effects of using Lexapro are:

  • Dry mouth
  • Heartburn
  • Diarrhea
  • Sleepiness or trouble sleeping
  • Bloated or full feeling
  • Runny nose
  • Unusual dreams
  • Muscle and joint aches
  • Increased sweating

Serious side effects that need medical attention include:

  • Fast or irregular heartbeat
  • Swelling of the face, hands, or ankles
  • Trouble breathing
  • Seizures
  • Increased thirst
  • Coma

Serotonin Syndrome

Something to watch closely for when taking any SSRI or SNRI is Serotonin Syndrome. This happens when there is too much serotonin in the brain.

Serotonin syndrome might happen when starting a new medication or increasing the dosage of a current medication. Symptoms of mild serotonin syndrome are:

  • Insomnia
  • Agitation
  • Confusion
  • Dilated pupils
  • Rapid heart rate
  • High blood pressure
  • Heavy sweating
  • Shivering, goosebumps
  • Muscle rigidity

Severe serotonin syndrome can lead to death. Symptoms are:

  • Irregular heartbeat
  • Unconsciousness
  • Seizures
  • Tremor
  • High fever

Modern Recovery Services Can Help People With OCD

The best way to treat OCD is a combination of medication and Cognitive Behavioral Therapy. This type of therapy helps people transform their thought patterns and change their lives.

Modern Recovery Services provides a variety of mental health services. We customize our services to meet each person’s situation and needs.

We have an online Intensive Outpatient Program (IOP) that can be done from anywhere in the United States. The online program is just as effective as an in-person IOP. You are not limited by your current location.

Being online has the added benefits of convenience and reduced costs.

At Modern Recovery Services, we are in-network with many insurance providers. We can verify your benefits to see what your insurance company will cover.

Your mental health or your loved one’s mental health is a priority. Please contact us today for more information.

Sources:

  1. International OCD Foundation. Who Gets OCD? 2022. Available at iocdf.org.
  2. National Institute of Mental Health. Obsessive-Compulsive Disorder. September 2022. Available at nimh.nih.gov.
  3. NHS. Symptoms- Obsessive Compulsive Disorder (OCD). November 18, 2019. Available at NHS.uk.
  4. National Library of Medicine. Defining Compulsive Behavior. April 23, 2019. Available at ncbi.nlm.nih.gov.
  5. Centers for Disease Control and Prevention. Obsessive-Compulsive Disorder in Children. April 11, 2022. Available at CDC.gov.
  6. Mayo Clinic. Obsessive-Compulsive Disorder (OCD). March 11, 2020. Available at Mayoclinic.org.
  7. Medline Plus. Obsessive-Compulsive Disorder. February 23, 2021. Available at medlineplus.gov.
  8. Mayo Clinic. Selective Serotonin Reuptake Inhibitors (SSRIs). September 19, 2019. Available at mayoclinic.org.
  9. National Library of Medicine. Serotonin Norepinephrine Reuptake Inhibitors: A Pharmacological Comparison. April 2014. Available at ncbi.nlm.nih.gov.
  10. U.S. Food & Drug Administration. Understanding Unapproved Use of Approved Drugs “Off Label”. February 5, 2018. Available at fda.gov.
  11. Medical News Today. What to Know About Tricyclic Antidepressants. August 30, 2021. Available at medicalnewstoday.com.
  12. Drugs.com. Anafranil. June 1, 2022. Available at drugs.com.
  13. National Library of Medicine. Extended-release Fluvoxamine and Improvements in Quality of Life in Patients With Obsessive-Compulsive Disorder. December 21, 2009. Available at pubmed.gov.
  14. Mayo Clinic. Fluvoxamine (Oral Route). October 1, 2022. Available at mayoclinic.org.
  15. Medline Plus. Paroxetine. 2022. Available at medlineplus.gov.
  16. Drugs.com. Prozac. December 1, 2021. Available at drugs.com.
  17. Medline Plus. Sertraline. January 15,2022. Available at medlineplus.gov.
  18. Medical News Today. Celexa (citalopram). October 26, 2019. Available at medicalnewstoday.com.
  19. Drugs.com. Effexor XR. December 1, 2021. Available at drugs.com.
  20. Mayo Clinic. Escitalopram (Oral Route). August 1, 2022. Available at Mayoclinic.org.
  21. Mayo Clinic. Serotonin Syndrome. January 22, 2022. Available at Mayoclinic.org.
  22. National Library of Medicine. Cognitive Behavioral Therapy. September 8, 2016. Available at ncbi.nlm.nih.gov.

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