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 behaviours in those who have obsessive-compulsive disorder (OCD).

How Well It Works

Research indicates 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.)

Health Canada and FDA Advisories. Health Canada and the US Food and Drug Administration (FDA) have issued:

• Advisories on antidepressant medicines and the risk of suicide. It is not recommended 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.
• Warnings 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

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

These medicines may take up to 12 weeks to relieve symptoms of OCD. It is possible that one of the medicines will work better for you than another. You may have to go through a trial of 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 anti-anxiety or antipsychotic medicine) also may be needed to effectively treat the combined disorders.

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.

Author:	Douglas Dana Sabra L. Katz-Wise	Last Updated: October 16, 2006
Medical Review:	Adam Husney, MD - Family Medicine Tom Bailey, MD - Family Medicine Lisa S. Weinstock, MD - Psychiatry
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