Antidepressant medicines used to treat OCD

Examples

Selective serotonin reuptake inhibitors (SSRIs):

Generic Name Brand Name
fluoxetine Prozac
fluvoxamine Luvox
paroxetine Paxil
sertraline Zoloft

Tricyclic antidepressant

Generic Name Brand Name
clomipramine Anafranil

How It Works

Antidepressants improve mood by affecting the levels of a chemical messenger in the brain (neurotransmitter) called serotonin.

Why It Is Used

Antidepressants are used to relieve obsessive thoughts and subsequent compulsive behaviors in those who have obsessive-compulsive disorder (OCD).

How Well It Works

Research shows that certain antidepressants improve symptoms of OCD and help balance brain chemicals.

Side Effects

Side effects of SSRIs (fluoxetine, fluvoxamine, paroxetine, and sertraline) can include:

  • Nausea.
  • Appetite changes or weight loss.
  • Headache.
  • Trouble sleeping and tiredness.
  • Nervousness.
  • Loss of sexual desire or ability and delayed orgasm.
  • Dizziness or shakiness (tremor).

Side effects of tricyclic medicine (clomipramine) can include:

  • Dry mouth.
  • Sweating.
  • Dizziness or shakiness (tremor).
  • Headache.
  • Constipation and/or stomach discomfort.
  • Inability to sleep (insomnia).
  • Seizures.
  • Rapid heartbeat (tachycardia).
  • Changes in personality.
  • Loss of sexual desire or ability or delayed orgasm.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.

What To Think About

For children and adolescents with OCD, treatment combining cognitive-behavioral therapy with antidepressants (SSRIs), such as sertraline, works better than only taking medicine. Cognitive-behavioral therapy alone also works well, but it works better if it is combined with medicine.1

You may start to feel better within 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 12 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor. It is possible that one of the medicines will work better for you than another. You may have to try several medicines before you find the right one.

If other mental health problems (such as depression) are present along with OCD, additional medicines (such as a mood stabilizer or an antianxiety or antipsychotic medicine) also may be needed to effectively treat the combined disorders.

Studies have found daily use of SSRIs may increase the risk of bone fracture in adults over age 50. Talk to your doctor about this risk before taking an SSRI.

SSRIs make bleeding more likely in the upper gastrointestinal tract (stomach and esophagus). Taking SSRIs with NSAIDs (such as Aleve or Advil) makes bleeding even more likely. Taking medicines that control acid in the stomach may help.2

Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating OCD.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Pediatric OCD Treatment Study (POTS) Team (2004). Cognitive-behavioral therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: The Pediatric OCD Treatment Study (POTS) randomized controlled trial. JAMA, 292(16): 1969–1976.
  2. Abajo FJ, Garcia-Rodriguez LA (2008). Risk of upper gastrointestinal tract bleeding associated with selective serotonin reuptake inhibitors and venlafaxine therapy. Archives of General Psychiatry, 65(7): 795–803.

Last Updated: June 25, 2008

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