OCD Treatments and Medications

Living with recurring uncontrollable thoughts, ideas, and behaviors can be challenging both mentally and physically. These are just some of the symptoms that characterize obsessive-compulsive disorder (OCD). Understanding what OCD is and how to treat it, with home remedies and medications, is essential for managing the condition.

What is OCD?

Obsessive-compulsive disorder (OCD) is a chronic mental health condition that is marked by recurring, uncontrollable thoughts and behaviors. It’s estimated that OCD is the sixth most common psychiatric disorder. People with OCD often feel a need to perform certain routines repeatedly (compulsions) or have intrusive thoughts that occur repeatedly (obsessions).

OCD can cause people to have obsessions and compulsions that range in topic and severity such as fear of being harmed, the need to rearrange objects, or repeatedly washing hands. The type of obsessions and compulsions will vary from person to person. OCD requires a medical diagnosis and is typically treated with medications, talk therapy, or a combination of the two.

How is OCD diagnosed?

The exact cause of OCD is not known, but doctors and researchers believe it could be caused by multiple factors such as family history, changes to the chemistry and functioning of the brain, and other mental illnesses or environmental factors. Anyone can experience OCD, but those who’ve been through stressful or traumatic events, or have family members who have OCD, will have a higher risk of developing the condition.

Symptoms that a doctor will look for to help determine whether or not someone has OCD include the presence of intrusive thoughts or urges, persistent thoughts or behaviors, obsessions or compulsions, and ritualistic behaviors. A person’s symptoms will often center around a certain theme such as keeping clean or avoiding personal harm. Stress typically makes symptoms worse, and the compulsions to repeat obsessive actions can be stressful, which can create a cycle that’s hard to break.

The severity of symptoms varies. Some people have mild to moderate symptoms, meaning they spend around one to three hours per day obsessing or completing compulsive behaviors. While severe symptoms may cause people to have nearly constant compulsions and obsessions, which can make it nearly impossible to function in daily life.

A primary care physician may refer you to a psychiatrist or psychologist who can properly diagnose OCD. If you think you have OCD and are planning to see a medical professional, here are some questions you could ask at your visit:

• How can treatment help me?

• If I do have OCD, what are the best treatment options?

• What can I do on my own to help myself?

During a trip to the doctor’s office that will likely include a mental and physical exam, a doctor may ask questions similar to these:

• When did your symptoms first start?

• How do your symptoms affect your daily life?

• Do you have repetitive thoughts or behaviors?

• Do any of your relatives have a mental illness?

• Does anything improve your symptoms?

Medical professionals typically recognize four themes or “symptom dimensions” for the types of symptoms OCD patients exhibit. If someone is diagnosed with OCD, they will probably have symptoms in one or more of these categories:

• Cleaning and contamination. People with this type of OCD will have symptoms such as worrying about germs, excessive hand washing or feeling unclean. They may have washing or cleaning rituals, may avoid potential sources of contamination, and they may have ongoing fear about coming into contact with unclean or toxic substances.

• Taboo, or forbidden thoughts and impulses. This type of OCD is characterized by stress related to thoughts that the patient thinks are wrong or forbidden. People may obsess over aggressive, sexual, or religious ideas, and may need frequent reassurance that they are capable of not acting on their intrusive and repetitive thoughts.

• Ordering and symmetry. Symptoms of this type of OCD include compulsions and rituals that are centered around arranging items in a certain way, repeating actions, or counting objects. People may feel incomplete or believe that something bad will happen to them if they don’t arrange or organize things in a particular way.

• Harmful thoughts. Having this type of OCD often comes with intrusive thoughts and feelings that may include fear of harm or injury happening to themselves or others. People may worry about causing something bad to happen if they don’t repeat certain actions, such as checking on things around the house or completing certain routines.

OCD treatment options

There is no cure for OCD but it can be treated symptomatically. Many people will live with OCD their entire lives but can learn to manage symptoms for a higher quality of life. Treatment of obsessive-compulsive disorder often involves a comprehensive approach that includes psychotherapy, medication, and lifestyle changes.

The most popular type of psychotherapy that mental health professionals use to treat OCD is called cognitive behavioral therapy (CBT). CBT works by helping the patient to cope with and change problematic behaviors, thoughts, and emotions.

“A specific type of cognitive behavior therapy (CBT) called exposure and ritual prevention (ERP) is the treatment of choice for OCD. This involves ‘on-purpose’ exposure or interaction with the situations that trigger thoughts and rituals (touching the floor, doorknob) and rather than engaging in the ritual to neutralize the anxiety of that moment, riding out the anxiety and ‘under-reacting.’ Because of neuroplasticity, the brain is able to relearn that those situations do not require redoing, rewashing, checking, etc., and over time the person with OCD re-wires their brain to not send danger signals about those stimuli,” explains Tamar Chansky, Ph.D., psychologist and founder of the Children’s Center for OCD and Anxiety.

Other than psychotherapy, certain medications can be very helpful for people with OCD. Anti-anxiety medications and antidepressants are commonly prescribed for OCD, and many people respond well to a combination of psychotherapy and some type of medication. Talking with a doctor or healthcare professional is the best way to determine if medications are the right choice based on your individual OCD symptoms.

OCD medications

Antidepressants and anti-anxiety medications are the most popular medications that doctors prescribe for patients with OCD. The type of medication prescribed will depend on the individual, symptoms, medical history, and response to treatment. It can take several weeks for medications to become effective, and patients may need to try several different medications to find the most effective option for them.

Antidepressants

Antidepressants are approved by the Food and Drug Administration (FDA) to treat OCD and work by increasing levels of certain neurotransmitters in the brain that help control obsessive thoughts and compulsive behaviors. Selective serotonin reuptake inhibitors (SSRIs) are a subcategory of antidepressants that are especially effective at treating OCD symptoms. Antidepressants may cause side effects such as dry mouth, nausea, trouble sleeping, and decreased sexual desire. Here are some of the most commonly prescribed antidepressants:

• Anafranil (clomipramine)

• Luvox (fluvoxamine)

• Prozac (fluoxetine)

• Paxil (paroxetine)

• Zoloft (sertraline)

• Lexapro (escitalopram)

• Celexa (citalopram)

Here’s a list of resources that could be helpful for comparing OCD medications:

• Paxil vs Zoloft

• Paxil vs Prozac

• Paxil vs Lexapro

• Lexapro vs Zoloft

What is the best medication for OCD?

There is no one universal OCD medication that’s best for everyone. Individual symptoms and responses to treatment vary. A doctor can determine the best medication for OCD based on an individual’s symptoms, medical history, and response to treatments. Here’s an overview of popular medications that a doctor may prescribe.

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What is the best medication for OCD?