Antidepressant medicines used to treat OCD

Examples

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Selective serotonin reuptake inhibitors (SSRIs):

Brand Name	Generic Name
Prozac	fluoxetine

Brand Name	Generic Name
Luvox	fluvoxamine

Brand Name	Generic Name
Paxil	paroxetine

Brand Name	Generic Name
Zoloft	sertraline

Tricyclic antidepressant

Brand Name	Generic Name
Anafranil	clomipramine

How It Works

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

Why It Is Used

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

How Well It Works

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

Side Effects

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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 Advisories. 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.
• A warning about the antidepressants Paxil or Paxil CR and birth defects. Taking these medicines in the first 12 weeks of pregnancy may increase your chance of having a baby with a birth defect.

What To Think About

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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.

If you are pregnant or nursing, you and your doctor need to decide whether taking an SSRI is appropriate.

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

References

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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.

Credits

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Author	Jeannette Curtis
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Lisa S. Weinstock, MD - Psychiatry
Last Updated	June 25, 2008