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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.

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.

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.

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.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.
  • Thoughts of suicide.
  • Agitation and restlessness.
  • Seizures.
  • A fast heartbeat.
  • Nausea and vomiting.

Common side effects of this medicine include:

  • Loss of sexual desire or ability.
  • Irritability.
  • Trouble sleeping or drowsiness.
  • Headache.
  • Changes in appetite.

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

The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.

What To Think About

Never suddenly stop taking antidepressants. The use of any antidepressant should be tapered off slowly and only under the supervision of a doctor. Abruptly stopping antidepressant medicine can cause negative side effects or a relapse into a depressive episode or anxiety disorder.

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

SSRIs can be safer than tricyclic or tetracyclic antidepressants, because they don't cause death if taken in large quantities (overdose). SSRIs usually are well tolerated and effective. SSRIs also may be safer for older adults, because the side effects are more tolerable.

People with liver disease usually need lower doses of SSRIs.

Studies have found that 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.1

SSRIs are also used to treat depression. SSRIs alone aren't commonly used if you have episodes of mania, such as in bipolar disorder.

Sexual dysfunction can be a significant problem for some people while taking an SSRI. A medicine such as sildenafil (Viagra) may help both men and women who have sexual problems caused by SSRIs.2, 3

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

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 your anxiety disorder.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

References

Citations

  1. 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.
  2. Nurnberg HG, et al. (2003). Treatment of antidepressant-associated sexual dysfunction with sildenafil. JAMA, 289(1): 56–64.
  3. Nurnberg GH, et al. (2008). Sildenafil treatment of women with antidepressant-associated sexual dysfunction: A randomized controlled trial. JAMA, 300(4): 395–404.

Credits

By Healthwise Staff
Primary Medical Reviewer Patrice Burgess, MD - Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry
Last Revised June 5, 2012

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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