Clinically Reviewed by Linda Whiteside, LPCC

Medically Reviewed by: Dr. Ryan Peterson, MD

Medication for OCD (Obsessive-Compulsive Disorder)

Table of Contents

Obsessive-Compulsive Disorder (OCD) is a type of mental health disorder that makes a person have unwanted and repeated thoughts, feelings, and ideas. These are called obsessions. Because of these obsessions, a person may do the same thing over and over again, like washing hands, checking if doors are locked, or repeating words. We call these actions compulsions. This behavior can affect one’s daily life and mental health.

When we talk about treating OCD, medication plays a big role. Medications can help control OCD symptoms so they do not interfere with a person’s everyday activities. But it’s important to remember that medication is not a cure for OCD. It’s a tool that helps manage symptoms.

There are many medications available to treat OCD. These include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). Each of these medications works in a different way to help control OCD symptoms. Let’s learn more about them.

What Is Obsessive-Compulsive Disorder (OCD)?

OCD is a type of mental health disorder. It makes people have recurring, unwanted thoughts or sensations (obsessions) that drive them to do something repetitively (compulsions). To be diagnosed with OCD, these obsessions and compulsions must take a lot of time and interfere with important activities.

Obsessions and Compulsions in OCD

In Obsessive-Compulsive Disorder (OCD), people experience obsessions and compulsions:

Obsessions: These are unwanted and repeated thoughts, images, or urges that cause distress. Examples of obsessions include:

  • Constant worry about germs or getting sick

  • Fear of harm coming to oneself or loved ones

  • Thoughts about doing things that are against one’s moral or ethical principles

  • Need for things to be arranged in a specific, perfect order

Compulsions: These are behaviors or mental acts that a person feels the urge to do in response to an obsession. Examples of compulsions include:

  • Excessive cleaning or handwashing due to fear of germs

  • Checking things repeatedly, such as whether the door is locked or the stove is off

  • Arranging items in a particular way or order

  • Repeating certain words, phrases, or prayers to prevent harm

Common Challenges Faced by Individuals Living with OCD

Living with OCD can present several challenges. Here are some of the common difficulties that OCD patients face:

  • Interference with daily life: OCD symptoms can interfere with important activities, like work, school, or social interactions. This can lead to problems in these areas.

  • Anxiety and distress: The obsessive thoughts and compulsive behaviors can cause significant anxiety and distress. This can affect a person’s overall well-being and quality of life.

  • Time-consuming: The compulsive behaviors often take up a lot of time, which can make it hard for people with OCD to do other things they need or want to do.

  • Co-occurring mental health disorders: Many people with OCD also have other mental health disorders, like anxiety disorders or depression. This can make treatment more complex.

  • Stigma and misunderstanding: There’s a lot of misunderstanding about OCD. People might think that those with OCD can just “stop worrying” or “stop doing” their compulsive behaviors. This can make people with OCD feel misunderstood or stigmatized.

Despite these challenges, there’s hope for those living with OCD. Treatments like cognitive behavior therapy, medications, and other forms of support can help individuals manage their OCD symptoms and improve their quality of life.

Treatment Approaches for OCD

Multiple treatment approaches have been proven effective for managing Obsessive-Compulsive Disorder (OCD):

  1. Cognitive Behavior Therapy (CBT): CBT is often the first line of treatment for OCD. It helps patients understand the relationship between their thoughts, feelings, and behaviors. Within CBT, a specific type called Exposure and Response Prevention (ERP) is highly effective for treating OCD.

  2. Medication: Several FDA-approved medications are available for treating OCD, most of which are types of antidepressants. These include Selective Serotonin Reuptake Inhibitors (SSRIs) and the Tricyclic Antidepressant (TCA) known as Clomipramine.

  3. Combination of Medication and Therapy: Often, a combination of medication and CBT can be more effective than either treatment alone. This comprehensive approach allows for the treatment of both the physical and psychological aspects of the disorder.

The Role of Medication in a Comprehensive OCD Treatment Plan

Medication plays a crucial role in the treatment of OCD, especially for those with severe symptoms. The primary medications prescribed include:

  1. Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs, including Fluoxetine, Sertraline, and Fluvoxamine, are often used as first-line treatment. They work by increasing the level of serotonin in the brain, which helps to reduce OCD symptoms.

  2. Tricyclic Antidepressants (TCAs): Clomipramine, a type of TCA, is often used when SSRIs are ineffective. It’s an older drug and can have more side effects than SSRIs, but it can also be highly effective.

  3. Antipsychotic Augmentation: For some patients who do not respond to SSRIs or TCAs, an antipsychotic medication may be added. This is known as antipsychotic augmentation.

  4. Other Medications: In some cases, other types of medications may be used, including other types of antidepressants or anti-anxiety drugs.

Therapy and Other Supportive Interventions

Several therapies and supportive interventions are helpful in managing OCD:

  1. Cognitive Behavioral Therapy (CBT): Specifically, a type of CBT known as Exposure and Response Prevention (ERP) is effective in reducing compulsive behaviors and obsessive thoughts.

  2. Group Therapy: Interacting with others who are also dealing with OCD can provide patients with perspective, strategies, and encouragement.

  3. Family Therapy: OCD can affect the entire family. This type of therapy helps families learn coping strategies and how to support their loved ones with OCD.

  4. Relaxation Techniques: Techniques like yoga, meditation, and controlled breathing can help to reduce the overall level of anxiety and stress, which can help to manage OCD symptoms.

  5. Lifestyle Changes: Regular exercise, a healthy diet, adequate sleep, and reducing caffeine and alcohol can all help to reduce symptoms of OCD.

In treating OCD, it’s important to understand that what works best will vary from person to person. It often takes time to find the right combination of treatments. The main goal is to reduce symptoms, improve quality of life, and help the person regain control over their thoughts and behaviors.

Selective Serotonin Reuptake Inhibitors (SSRIs) for OCD Treatment

Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of medications commonly used in the treatment of Obsessive Compulsive Disorder (OCD). Their mechanism of action includes:

  • Serotonin Regulation: SSRIs work by inhibiting the reabsorption, or reuptake, of serotonin in the brain, leading to increased availability of this neurotransmitter.

  • Impacting Nerve Cell Function: By increasing the level of serotonin, SSRIs impact the communication between nerve cells, which can affect mood and behavior.

  • Improving Symptoms: Over time, this enhanced serotonin system helps to decrease the intensity of obsessive thoughts and compulsive behaviors associated with OCD.

The efficacy of SSRIs in reducing OCD symptoms is well documented. Regular use of SSRIs can make obsessions and compulsions less severe and easier to manage. However, it’s important to note that the full benefit of these medications may not be apparent for several weeks after beginning treatment. For most OCD patients, long-term treatment with SSRIs is necessary to maintain symptom control.

While SSRIs are generally well tolerated, they can have side effects. It’s essential to be aware of these and to discuss them with a mental health professional. These can include nausea, dry mouth, fatigue, and weight gain.

If side effects are severe or disruptive, the healthcare provider may adjust the dose or switch to a different medication. Regular follow-up with the healthcare provider is necessary to monitor progress, manage side effects, and adjust treatment as necessary.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) and Tricyclic Antidepressants (TCAs)

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) can be considered when SSRIs aren’t effective. They work similarly to SSRIs but also affect other neurotransmitters. SNRIs increase the levels of both serotonin and norepinephrine in the brain, which can enhance their effectiveness.

Tricyclic Antidepressants (TCAs) have been used for decades to treat various psychiatric disorders, including OCD. Clomipramine, a TCA, has been shown to be particularly effective in treating OCD symptoms. Despite their effectiveness, TCAs are usually reserved for use when other treatments have failed due to their potential side effects and safety concerns.

Comparing Different Classes of Antidepressants for OCD

The choice between SSRIs, SNRIs, and TCAs will depend on the individual’s specific symptoms, overall health, and response to treatment:

  1. SSRIs: Typically considered first-line treatment for OCD due to their effectiveness and relatively mild side-effect profile.

  2. SNRIs: These may be considered if SSRIs are ineffective or not tolerated.

  3. TCAs: Although effective, they are usually reserved for severe cases or when other treatments haven’t worked due to the risk of more serious side effects.

In all cases, the goal of treatment is to reduce symptoms, improve quality of life, and enable the individual to regain control over their thoughts and behaviors.

Adjunctive Medications and Augmentation Strategies

Atypical Antipsychotics as Adjunctive Medications in OCD Treatment

In some cases of severe OCD, adjunctive medications are added to the existing treatment to increase its effectiveness. Atypical antipsychotics, a class of medications that work differently from traditional antipsychotics, can serve this purpose:

  • Risperidone (Risperdal): Frequently used as an adjunctive medication and has shown benefits in several studies.

  • Quetiapine (Seroquel): It may be beneficial for those who do not respond adequately to SSRIs alone.

  • Olanzapine (Zyprexa): While not a first-line adjunctive treatment, it may be considered for treatment-resistant OCD.

  • Aripiprazole (Abilify): Evidence suggests that this medication can enhance the efficacy of SSRIs in OCD treatment.

Augmenting Antidepressants with Other Medications for Treatment-Resistant Cases

In cases where OCD symptoms don’t improve significantly with a single medication, an augmentation strategy may be employed. This involves adding a second medication to the treatment plan:

  • Benzodiazepines: For short-term relief of acute symptoms, these drugs can be useful, but they are not typically a long-term solution due to the risk of dependency.

  • Mood Stabilizers: Medications like lithium or valproate may be considered in patients with comorbid bipolar disorder.

  • NMDA Antagonists: Medications like memantine have shown promise in some studies for treatment-resistant OCD.

  • Other Antidepressants: In some cases, combining two different types of antidepressants, such as an SSRI with a TCA, can be beneficial.

Medication Selection and Individualized Treatment

Factors to Consider in Medication Selection for OCD

Choosing the right medication for obsessive-compulsive disorder (OCD) is critical and depends on several factors:

  • Symptom Severity and Type: Certain medications may work better for specific types of obsessions or compulsions.

  • Age: The age of the patient is vital as some medications are not approved for children or adolescents, while others may require adjusted dosing.

  • Overall Health: Existing medical conditions may affect the choice of medication, as some drugs can exacerbate certain health problems.

  • Previous Response to Medications: If the individual has tried certain medications in the past without success or if they experienced significant side effects, these medications may not be the best choice.

  • Co-Occurring Mental Health Disorders: Other mental health disorders, such as generalized anxiety disorder or panic disorder, could influence medication choice.

The decision-making process for choosing a medication should involve the person with OCD, their family, and the mental health professional. This collaborative approach is beneficial for several reasons:

  • It ensures all parties have a shared understanding of the benefits, risks, and alternatives of each treatment option.

  • It can enhance treatment compliance, as the individual is more likely to adhere to a treatment plan they were involved in forming.

  • It empowers patients by giving them an active role in their treatment.

OCD treatment should be tailored to each individual, as each person’s experience with OCD is unique. Regular check-ups with the healthcare professional are important to ensure the effectiveness of the treatment plan:

  • Regular Check-Ups: These allow for monitoring the effectiveness of the medication, side effects, and overall mental and physical health.

  • Dose Adjustment: Depending on the response to the medication, the healthcare provider may need to adjust the dose or switch to a different medication.

  • Monitoring Side Effects: Close monitoring of potential side effects is necessary for maintaining the safety and well-being of the individual.

  • Addressing Co-Occurring Conditions: Regular check-ups allow the healthcare professional to identify and manage other co-occurring disorders or medical conditions.

  • Reviewing Progress: Regular review of the individual’s progress can motivate them to continue with their treatment, especially in the first few weeks when improvement may not yet be noticeable.

The key to successful treatment of OCD lies in a personalized, patient-centered approach involving close collaboration between the patient and the healthcare provider. Through this approach, individuals with OCD can manage their symptoms and improve their quality of life.

Managing Side Effects and Maximizing Treatment Benefits

Common Side Effects of OCD Medications

People undergoing pharmacological treatment for obsessive compulsive disorder (OCD) may experience various side effects. Here are some common side effects associated with OCD medications:

  • Nausea: An uneasy feeling in the stomach which may lead to vomiting.

  • Dry Mouth: A decrease in the production of saliva, leading to a feeling of dryness in the mouth.

  • Sleep Disturbances: Insomnia or excessive sleepiness can be common.

  • Weight Changes: Either weight gain or loss can be experienced.

  • Sexual Side Effects: Changes in sexual desire or performance may occur.

  • Fatigue: Feeling excessively tired or weak.

  • Sweating: Increased perspiration.

  • Diarrhea or Constipation: Changes in bowel movements.

  • Nervousness: Feeling anxious or on edge.

  • Dizziness: Feeling unsteady, lightheaded, or having a sensation of spinning.

  • Cognitive Changes: Some people might experience difficulties with memory or concentration.

  • Increased Anxiety: While medications aim to reduce anxiety, during the first few weeks, some individuals might experience a temporary increase in anxiety symptoms.

Strategies for Minimizing Side Effects and Promoting Medication Adherence

To minimize the impact of these side effects and promote adherence to the medication regimen, the following strategies may be helpful:

Start with a Low Dose: Many side effects can be minimized by starting with a lower dose and gradually increasing it over time.

Monitor Side Effects: Regularly recording side effects can help the healthcare provider make necessary adjustments.

Healthy Lifestyle: Engaging in regular exercise, maintaining a balanced diet, and ensuring adequate sleep can help manage some side effects.

Compliance: Ensuring medication is taken consistently and as prescribed is critical to minimize potential side effects and achieve the best outcome.

Open Communication: Individuals should openly communicate any side effects or concerns to their healthcare provider.

Treatment of Side Effects: Some side effects can be managed with additional medications or treatments.

Patient Education: Understanding the purpose, benefits, and potential side effects of the medication can promote adherence.

Regular Assessment and Adjustments for Optimal Treatment Outcomes

For the best outcomes, regular check-ups with the healthcare professional are critical. During these check-ups:

  1. Effectiveness Assessment: The healthcare provider can evaluate the effectiveness of the medication and adjust the dose or switch to a different medication if necessary.

  2. Side Effect Monitoring: Regular monitoring of side effects can ensure that they are managed appropriately and that serious side effects are identified and addressed promptly.

  3. Continuous Support: Regular check-ups provide an opportunity for the healthcare provider to offer continuous support and reassurance, which can be beneficial in managing OCD.

By following these strategies and maintaining regular check-ups, individuals with OCD can manage side effects effectively, maximize the benefits of treatment, and improve their quality of life.

Combining Medication with Cognitive Behavioral Therapy (CBT)

Medication and CBT can work well together to treat OCD. The medication can help reduce symptoms, while CBT can teach skills to manage them better.

ERP is a type of CBT that is often used to treat OCD. It involves gradually facing fears and learning not to respond to them with compulsive behaviors.

Working together with the healthcare professional and therapist is important when combining medication and therapy. This can ensure the treatment plan is working well.

Potential Benefits and Considerations of Combination Therapy

While combination therapy can be beneficial for some patients, it comes with its own considerations:

  • Increased Efficacy: The primary benefit of combination therapy is the potential for enhanced symptom relief.

  • Personalized Treatment: Combination therapy allows for a more personalized treatment approach, potentially addressing various aspects of the disorder.

  • Increased Side Effects: Combining medications can also increase the risk of side effects, including interactions between medications.

  • Monitoring: Close monitoring is necessary to ensure that the combination is both effective and well-tolerated.

  • Slow Titration: It’s generally recommended to start one medication at a time, at a low dose, and increase slowly. This helps minimize side effects and allows the healthcare provider to better assess the effects of each medication.

  • Patience: Due to the complex nature of OCD, treatment requires patience. It can take several weeks to observe the effects of a new medication or combination.

While OCD is a challenging disorder to treat, a range of pharmacological treatments and strategies exist. The choice of medication, whether a single drug or a combination, should be tailored to the individual’s specific symptoms, overall health, and response to treatment. It’s crucial to maintain close collaboration with a healthcare provider to optimize treatment outcomes.

Long-Term Management and Relapse Prevention

Most people with OCD will need to continue taking medication for a long time, maybe even for life. This is called maintenance treatment. It can help keep symptoms under control and prevent them from coming back.

Aside from medication, therapy can help by teaching useful coping skills for managing OCD symptoms. It can also help prevent relapse, which is when symptoms come back after getting better.

Support groups, self-help books, and online resources can also be very helpful for people living with OCD. They can provide practical advice and emotional support.


Medication plays a key role in treating OCD. It can help control OCD symptoms and improve quality of life. Many different medications are available, and a healthcare professional can help decide which one is best.

If you or someone you know has OCD, it’s important to seek help from a mental health professional. They can explain the treatment options, including medication, and support you through the treatment process.

Effective treatment, including medication, can help people with OCD live a full and happy life. There’s always hope for a better tomorrow. Reach out for help, and remember you are not alone.

With proper care, support, and treatment, life with OCD can be not only manageable but also fulfilling and joyful. There’s always help available, and it’s never too late to seek it. Remember, you’re not alone in this journey; with the right help and approach, you can overcome the challenges that OCD presents.

Take Control of Your Life with NuView Treatment Center

Don’t let OCD dictate your life any longer. While navigating through the complexities of obsessive compulsive disorder can be challenging, you don’t have to face this battle alone. NuView Treatment Center is committed to providing you with the necessary tools and support to reclaim control over your life.

At NuView, our personalized approach to OCD treatment includes a broad range of evidence-based therapies and medication management strategies. Our dedicated and compassionate team of professionals are experts in diagnosing and treating OCD, and we’re ready to work with you to create a personalized treatment plan that suits your unique needs and preferences.

The journey to recovery may seem daunting, but remember, the strongest steps are often the first ones. Reach out to us today, and let’s take that first step together. Trust NuView Treatment Center – your partner on your path to a healthier, happier, OCD-free life.

Contact NuView Treatment Center now to book your first consultation. Your future self will thank you.

Frequently Asked Questions (FAQs)

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Yes, several medications, including Selective Serotonin Reuptake Inhibitors (SSRIs) and Tricyclic Antidepressants (TCAs), have been approved by the FDA for the treatment of OCD. Consult a healthcare professional to explore these options.

In certain cases where OCD is resistant to treatment, a mental health professional may suggest an “augmentation” strategy, which involves prescribing more than one medication.

While some herbal supplements are marketed to manage OCD symptoms, their effectiveness varies widely and isn’t generally as well-studied as standard medications. Always consult your healthcare professional before starting any new treatment.

Yes, OCD can be treated with various types of therapy, such as Cognitive Behavioral Therapy (CBT) and, specifically Exposure and Response Prevention (ERP) therapy. However, many people find the most relief from a combination of medication and therapy.

Alcohol can interfere with the effectiveness of OCD medications and increase their side effects. It’s best to discuss your alcohol consumption with your healthcare provider.

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Kellner, Michael. “Drug treatment of obsessive-compulsive disorder.” Dialogues in clinical neuroscience vol. 12,2 (2010): 187-97. doi:10.31887/DCNS.2010.12.2/mkellner

Soomro, G M et al. “Selective serotonin re-uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD).” The Cochrane database of systematic reviews vol. 2008,1 CD001765. 23 Jan. 2008, doi:10.1002/14651858.CD001765.pub3

Dell’Osso, Bernardo et al. “Serotonin-norepinephrine reuptake inhibitors in the treatment of obsessive-compulsive disorder: A critical review.” The Journal of clinical psychiatry vol. 67,4 (2006): 600-10. doi:10.4088/jcp.v67n0411

Foa, Edna B. “Cognitive behavioral therapy of obsessive-compulsive disorder.” Dialogues in clinical neuroscience vol. 12,2 (2010): 199-207. doi:10.31887/DCNS.2010.12.2/efoa

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Written By: Linda Whiteside

Licensed Clinical Professional Counselor who has been providing mental health services for over 10 years.

Medically reviewed by: Dr. Ryan Peterson

Went to medical school at The George Washington University School of Medicine in Washington, D.C.

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