OCD Medications

What Are The Symptoms of OCD?

Most people with OCD will experience a combination of obsessions and compulsions, though, in some instances, they may only deal with one symptom cluster. In OCD, these symptoms dramatically impact a person’s ability to function. Work, school, and personal relationships are all affected in untreated OCD cases.

Obsessions typically have themes, and the most common ones include:

• Experiencing sudden, violent thoughts toward themselves or others
• Having an irrational fear of germs and contamination
• Intrusive thoughts about things that are taboo and forbidden
• Needing items to be in perfect order or facing a particular direction
• Having to touch objects a certain way or in a specific order to feel less anxious

A compulsion, the other side of the OCD coin, is repetitive behavior. People with OCD will feel an irrational urge to perform a compulsion or OCD ritual to alleviate their feelings of anxiety or fear or to prevent an obsession from occurring. Some of the most common types of compulsions in OCD are:

• Compulsive, repetitive hand washing to alleviate feelings of contamination
• Putting objects in a precise order that they can’t deviate from
• Locking, unlocking, and relocking a door to get rid of anxiety about home invasions
• Counting compulsively, either out loud or in their head

Do OCD Symptoms Go Away On Their Own?

OCD symptoms, like many mental health disorder symptoms, will ebb and flow in severity. Times of stress, uncertainty, and change can all influence symptoms. Without treatment, many people with OCD will attempt to avoid certain triggers that may cause their symptoms to flare.

OCD patients who experience worse symptoms in social situations may begin to isolate themselves. Without intervention, people with OCD may not learn healthy coping mechanisms for stress and will continue to develop compulsions to alleviate their symptoms. But this feeds into a vicious cycle.

Does Medication for OCD Work?

Medication is continuously being researched for its effectiveness in managing OCD symptoms. Studies show that a 25% to 35% improvement on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is considered a positive response to medication therapy. For many people, this improvement translates into feeling less burdened by obsessive thoughts and compulsive behaviors, which allows them to regain a sense of normalcy in their lives.

That said, medication isn’t a universal solution. Some individuals may still experience residual symptoms or find that their condition doesn’t respond to standard medications. Things like the severity of OCD, early onset, co-occurring conditions, or difficulty following a treatment plan can all influence how well medications work.

Types of Medications for OCD

When treating OCD with medication, doctors will either prescribe an antidepressant or an off-label medication, like an antipsychotic. Each type of medication works differently to treat symptoms, and treatment plans are customized based on individual needs and responses.
Antidepressants for OCD
Selective serotonin reuptake inhibitors (SSRIs) are the first-line medication for OCD, thanks to their effectiveness and safety profile. These medications increase the availability of serotonin in the brain, which can help regulate mood and reduce obsessive-compulsive symptoms.

Studies show that up to 60% of people respond to SSRI treatment, and higher doses may lead to even better outcomes. FDA-approved SSRIs for OCD include:

• Fluoxetine
• Fluvoxamine
• Paroxetine
• Sertraline

Other SSRIs that are not FDA-approved for the treatment of OCD but can be used off-label include citalopram and escitalopram.

Another medication option for OCD treatment is clomipramine, an older antidepressant that boosts both serotonin and norepinephrine levels. Research suggests clomipramine may be more effective than SSRIs, but its higher risk of side effects means it’s usually considered when SSRIs don’t work.

Other Medications for OCD

In cases where SSRIs or clomipramine aren’t enough, antipsychotic medications may be added to strengthen treatment. These medications are not recommended as a stand-alone option but can be helpful when used in conjunction with antidepressants. Examples of antipsychotics that may be used off-label for OCD include:

• Aripiprazole
• Haloperidol
• Olanzapine
• Quetiapine
• Risperidone

However, using antipsychotics for OCD is a balancing act. While they can improve symptoms in some people, they may also worsen obsessive-compulsive behaviors in others. This is why their use is typically reserved for situations in which traditional treatments haven’t been effective.

Tips for Managing Side Effects

Most side effects are mild and subside within the first few weeks as your body adjusts to the medication. However, some may persist or require medical attention. It’s important to stay in touch with your doctor throughout your treatment, especially if you have concerns about your medication or how it’s affecting you. Reach out to your healthcare provider if:

You have questions or feel unsure about your medication or its side effects
You haven’t noticed any improvement in your symptoms after a few weeks of consistent use
You start to experience feelings of hopelessness or thoughts of self-harm

If you notice more serious side effects, such as allergic reactions, difficulty breathing, abnormal bleeding, or a rash that won’t go away, contact your doctor right away, or go to your nearest emergency room.

Medication is just one piece of the puzzle when treating OCD. In fact, many people find that pairing it with therapy gives them better results. Psychotherapy is a common choice, and for some, it can be just as effective as medication.

One type of psychotherapy that may be helpful in managing symptoms is Cognitive Behavioral Therapy (CBT). CBT focuses on recognizing and changing negative thought patterns that may exacerbate OCD symptoms. It gives people a full picture view of their thoughts and helps them to develop healthier and more constructive ways to respond.

Another option is Exposure and Response Prevention (ERP). In ERP, patients will face situations that trigger their obsessions, like walking away from the stove without repeatedly checking if it’s off, and resisting the compulsion to check. At first, this can be uncomfortable and may even trigger anxiety, but with time and practice, many people find that their compulsions become less overbearing.

For those with treatment-resistant OCD, Transcranial Magnetic Stimulation (TMS) is another consideration. This non-invasive therapy uses magnetic pulses to target specific areas of the brain that are responsible for OCD symptoms. It’s often used alongside medication or psychotherapy.