There is no medication specifically for obsessive-compulsive disorder (OCD). However, doctors can prescribe antidepressants or other types of drugs to reduce the symptoms.
The Food and Drug Administration (FDA) has approved a handful of antidepressants for treating OCD, but doctors can prescribe other drugs “off-label” if the FDA-approved options are unsuitable.
There is no medication for OCD that will work equally well for everyone. People can have different responses to different drugs. As such, a person may need to try a few medications before they find one that suits them.
In this article, learn about the medications commonly prescribed for OCD, including their side effects and risks, and additional methods of OCD treatment.
There is no objective “best” medication for OCD. Drugs that doctors prescribe for mental health symptoms often affect people differently. A given drug may generate a significant response in some people and a weak response in others.
Also, drug companies have not developed any medications specifically for OCD. As a result, doctors typically start by recommending antidepressants.
Antidepressants treat the symptoms of depression, but sometimes, people find they can also help with other mental health conditions, such as:
There are several types of antidepressants. The ones doctors
Both SSRIs and SNRIs affect a person’s neurotransmitters, which are chemicals that carry signals between neurons. SSRIs increase serotonin, while SNRIs increase serotonin and norepinephrine.
The FDA has approved certain antidepressants specifically for the treatment of OCD symptoms. They are:
- fluoxetine (Prozac)
- fluvoxamine (Luvox)
- paroxetine (Paxil, Pexeva)
- sertraline (Zoloft)
- clomipramine (Anafranil)
The International OCD Foundation (IOCDF) lists a few other antidepressants that doctors may prescribe off-label for OCD. They include:
- citalopram (Celexa)
- escitalopram (Lexapro)
- venlafaxine (Effexor)
The type and dose of antidepressant a doctor prescribes will depend on factors such as the person’s age, the severity of their symptoms, and any other medical conditions they have. Doctors usually start with small doses and gradually increase them to find the ideal amount for each person.
It can take several weeks to a few months for someone to feel the benefits of these drugs. Below is more information on certain FDA-approved medications for OCD.
Fluoxetine is an SSRI antidepressant.
The drug helps manage phobic symptoms equally effectively with both short-term and medium-term use.
Paroxetine (Paxil, Pexeva)
Paroxetine is also an SSRI. Studies have shown that doses of
Sertraline is another SSRI antidepressant. For OCD, sertraline is
Sertraline is available as a tablet and liquid.
Clomipramine is a tricyclic antidepressant. It behaves much like an SSRI in that it boosts the amount of serotonin in the brain.
Regarding OCD treatment, clomipramine has
Sometimes, doctors prescribe other medications when treating OCD. These may include benzodiazepines and antipsychotics.
Benzodiazepines are a type of central nervous system (CNS) depressant. CNS depressants slow down brain activity, which can help a person feel calm and relaxed.
However, the body becomes dependent on these drugs quickly, which can make it difficult to stop taking them. As a result, doctors typically only prescribe them for one-off or short-term use.
Some common benzodiazepines include:
- alprazolam (Xanax)
- clonazepam (Klonopin)
- diazepam (Valium)
- lorazepam (Ativan)
- midazolam (Versed)
Misusing these drugs is extremely dangerous. It is important for anyone taking a benzodiazepine medication to do so only as prescribed and with medical supervision.
Antipsychotics are drugs doctors prescribe to treat psychosis, but they can sometimes also help with symptoms of anxiety disorders, such as OCD.
A 2018 review on the use of the antipsychotic drugs aripiprazole, paliperidone, and risperidone found there may be a place for these medications in treating OCD when other medications, particularly SSRIs, have failed or not worked sufficiently.
Researchers found that, while there is no evidence supporting preferential use of one antipsychotic drug over the others, risperidone appears to be more effective in some people. However, aripiprazole and paliperidone have fewer negative side effects.
The authors also emphasize the need for larger studies to confirm the benefits.
All drugs a doctor might prescribe for OCD have risks and potential side effects.
Antidepressants and antipsychotics
According to IOCDF, most people who take an antidepressant for OCD will experience one or more side effects from the drug. Some of the most common side effects of antidepressants and antipsychotics include:
- dry mouth
- anxiety or agitation
- nausea, vomiting, or diarrhea
- sweating or hot flashes
- weight gain or loss
- sexual dysfunction
- fatigue or insomnia
More serious side effects include:
- worsening depression
- serotonin syndrome
- abnormal bruising and bleeding
- low salt levels in the blood
- cardiac conditions
- new suicidal thoughts and behavior
Additionally, people may experience serious side effects when they take an antidepressant or antipsychotic drug while taking other medications or supplements.
For example, someone taking monoamine oxidase inhibitors while taking another medication could experience dangerously high blood pressure levels.
A person’s doctor can help them safely discontinue the use of an antidepressant or antipsychotic. Stopping suddenly can lead to withdrawal symptoms, including fatigue, dizziness, and nausea. This is known as antidepressant discontinuation syndrome.
Learn more about antidepressant discontinuation syndrome.
Benzodiazepines also can cause worsened depression and anxiety, drowsiness, and dizziness. Other potential side effects include:
- loss of coordination
- changes in memory
- behavioral changes, such as a loss of inhibition and risk-taking
There is also a risk of dependency if a person takes this type of drug for too long and a risk of overdose if they begin to misuse them.
It is important that a person talks with their doctor about all other medications or substances they take, as some interactions can decrease or increase the effectiveness of benzodiazepines.
Discontinuing benzodiazepines may cause withdrawal symptoms ranging from anxiety and depression to confusion and mood shifts. People should never suddenly stop taking benzodiazepines without speaking with a doctor first, as this can be dangerous.
A combination of medication and therapy can be the
One of the most common therapies for OCD is exposure and response prevention (ERP). ERP is a type of cognitive behavioral therapy (CBT) that focuses on gradually exposing a person to their fear or obsession while helping them learn new ways of coping with that fear.
There is a large body of research and literature supporting ERP’s effectiveness. An older
People who began experiencing OCD symptoms after one or more traumatic events may also find trauma therapy helpful. This can include trauma-focused CBT, as well as other types of therapy, such as eye movement desensitization and reprocessing (EMDR).
There are other options in addition to therapy and medication. These include:
- Deep brain stimulation: This involves surgically placing several electrical devices in the person’s brain to regulate brain activity.
- Transcranial magnetic stimulation: This is a nonsurgical method of sending electrical impulses to the brain.
- Intensive programs: In these treatment programs, a person immerses themselves in various therapies for an uninterrupted block of time. They can include day programs, residential programs, and inpatient programs in a hospital.
Below are answers to some frequently asked questions about OCD medications.
Are antidepressants safe for everyone?
No. While antidepressants are typically safe, each antidepressant is not safe for each person.
For example, doctors consider a person’s age, existing health conditions, and whether the person is pregnant or breastfeeding before prescribing an antidepressant.
Can a person take OCD medication only when they feel symptoms?
Doctors instruct people to take antidepressants and antipsychotics on a schedule. For example, a person may take one pill daily at around the same time. Taking these drugs occasionally or sporadically will render them ineffective.
However, people can take benzodiazepines occasionally. For example, a person who is anxious about flying might only take them when they are on a plane.
Should a person avoid alcohol while taking OCD medications?
Yes. Mixing alcohol and benzodiazepines can be fatal. For antidepressants, people should wait and see how the drug affects them before trying alcohol.
After several weeks of taking the medication, a person can ask their doctor whether it is OK to drink alcohol.
Do people with OCD need to take medication forever?
No, not necessarily. Some people only take medications to reduce their symptoms while they begin therapy. Some people may find they no longer need their medication after some time. Others may want to keep taking it.
What if someone can not afford medication or therapy?
There are a few options for low cost or free OCD treatment. They include:
- medication discount vouchers
- medication sample packets
- free or low cost therapy
People can visit PhRMA’s Medicine Assistance Tool (MAT) to search for what is available to them, including information on health insurance, Medicaid, and Medicare.
The best medication for OCD symptoms depends on the person, how they respond to specific drugs, and other factors.