Medicines and Products for obsessive-compulsive disorder

Medicines can reduce OCD symptoms, especially when combined with therapy. They should only be started, changed or stopped by a doctor, usually a psychiatrist.

First-line medicines

• SSRIs (selective serotonin reuptake inhibitors): such as fluoxetine, sertraline, fluvoxamine, paroxetine, escitalopram and citalopram. OCD often needs higher doses and 8 to 12 weeks to show full benefit.
• Clomipramine: an older medicine with strong evidence, used when SSRIs are not enough, with more side effects

Possible side effects

Nausea, headache, sleep changes, restlessness, sexual side effects, weight changes and, early on, feelings of anxiety. In young people, mood and suicidal thoughts need close watching in the first weeks. Report any new distress to the doctor.

Add-on medicines

If symptoms remain, a psychiatrist may add a low dose of an antipsychotic or another medicine.

Important cautions

• Never stop an SSRI suddenly, which can cause withdrawal symptoms and relapse
• Avoid alcohol
• Tell your doctor about all medicines, herbs and supplements, since interactions can be serious
• Pregnancy and breastfeeding need an individual plan with the doctor, so do not stop medicine on your own
• Children and teens: use only under a child psychiatrist's care
• Avoid buying psychiatric medicines without a prescription

Other treatments

For severe OCD that does not respond, specialists may offer options such as transcranial magnetic stimulation (TMS) or other treatments.

Remember

Be patient, since benefit takes weeks. Take medicines as prescribed and attend follow-up visits.