Managing Medications: Obsessive Compulsive Disorder

Living with obsessive compulsive disorder can create situations that range from mildly annoying to seriously debilitating. Patients may find themselves somewhere on the spectrum between washing their hands constantly to obsessively repeating behaviors that interfere with their daily lives and even their ability to go to a job.

There are a handful of different medications that physicians regularly rely on to treat obsessive compulsive disorder. Your doctor may prescribe a single one or a combination of these medicines. Other medications, such as those for anxiety or to help you sleep, may also be used to compliment OCD treatment and may be able to significantly increase quality of life by decreasing obsessive thoughts.

Selective Serotonin Reuptake Inhibitors (SSRIs)

How they work: These medications regulate the amount of serotonin in the brain, making compulsive behaviors and obsessive thoughts less likely.

Zoloft (generic name: sertraline)*

Common side effects: Decreased libido, erectile dysfunction, sexual difficulties, insomnia, diarrhea, dizziness, headache, appetite loss, dry mouth, nausea, stomach cramps, low energy, excessive sweating, gas, weakness, involuntary twitching, weight loss.

User experience: “I tried Zoloft in college for depression because relatives said it had worked for them for social anxiety too, so I was hoping it would be a cure. Instead, I ended up in a manic state with racing thoughts and I couldn’t sleep. I was pacing my dorm room and not leaving it for days at a time. It also gave me uncontrollable diarrhea.” Jean Rose,** diagnosed with OCD in her 20s.

Prozac (generic name: fluoxetine)*

Common side effects: Anxiety, insomnia, nausea, excessive sweating, weakness, headache, diarrhea, dizziness, indigestion, nervousness, appetite loss, rash, yawning, throat irritation, dry mouth, involuntary twitching, sinus irritation and/or congestion.

User experience: “I was on it at 14, and it made me very, very emotional,” says Jean Rose. “I tried it again in my early 30s, and the side effects with bowels proved intolerable.”

Paxil (generic name: paroxetine)*

Common side effects: Difficulty emptying bladder, insomnia, drowsiness, weakness, nausea, headache, sexual difficulties, appetite loss, difficult or painful urination, diarrhea, dry mouth, involuntary twitching, excessive sweating, nervousness, bowel movement difficulties.

User experience: “Paxil turned me into a zombie. I didn’t care anymore, I just slept all the time. That was fine for me, but my mom got worried,” Jean Rose says.

Luvox (generic name: fluvoxamine)*

Common side effects: Insomnia, dizziness, diarrhea, sexual difficulties, drowsiness, excessive sweating, weakness, indigestion, involuntary twitching, dry mouth, nausea, headache, bowel movement difficulties, nasal swelling, nervousness, taste problems.

Serotonin norepinephrine reuptake inhibitors (SNRIs)

How they work: Effexor is the most typical SNRI used to treat OCD symptoms. It balances serotonin and norepinephrine in the brain and is used to treat many anxiety disorders.

Effexor (generic name: venlafaxine)

Common side effects: Blurry vision, headache, visual problems (such as inability to focus), vomiting, nervousness, dry mouth, excessive sweating, quivering, numbness and/or tingling, appetite loss, stomach problems, taste problems, insomnia, drowsiness, dizziness, weakness, bowel movement difficulties, sexual difficulties, anxiety.

User experience: “I was on Effexor twice. The first time, I was nauseous. The second time, the bowel problems were too much,” Jean Rose says.

Tricyclic antidepressants

How they work: These are similar to SSRIs and SNRIs, but only one tricyclic is approved by the Food and Drug Administration for treatment of OCD. It’s generally only used when other drugs do not work.

Anafranil (generic name: clomipramine)*

Common side effects: Lack of energy, insomnia, dry mouth, headache, visual difficulties, taste problems, appetite loss, indigestion, weight gain, dizziness, drowsiness, erectile dysfunction, hunger.

User experience: “Anafranil had no effect for me,” Jean Rose says.

Bottom line:

Remember, side effects may go away within a few weeks of starting treatment. Be sure to take your medication as instructed and do not skip doses. Work closely with your physician to find the right medication or combination of medications for you. Finding the best balance of side effects and relief will likely take some trial and error.

* = FDA approved

** = Name has been changed to protect privacy


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