Obsessive-compulsive disorder(OCD) is commonly treated with both medication andcognitive behavioral therapy.
Their positive effects can often be felt within two weeks of starting treatment.
Anafranil is atricyclic antidepressantthat is FDA-approved to treat OCD.
Jose A. Bernat Bacete / Moment Open / Getty Images
Dosages
When treating OCD, SSRI doses are usually higher than those used for depression.
Your primary care provider will probably start you on a low dose to begin and increase it if needed.
Many still have residual symptoms, though.
Get our printable guide to help you ask the right questions at your next doctor’s appointment.
Two SSRIsCelexa (citalopram) and Lexapro (escitalopram)are sometimes prescribed off-label to treat OCD.
Side Effects
Like all psychiatric medications, antidepressant OCD medications may cause side effects.
Always talk to your physician about the side effects you are experiencing and any concerns you may have.
Antipsychotic OCD Medications
Two types ofantipsychotic medicationscan be used to treat OCD: first-generation and second-generation antipsychotics.
Second-generation antipsychotics, also known asatypical antipsychotic medications, are usually chosen to augment SSRIs.
There are no specific dosing recommendations for antipsychotic augmentation for OCD.
Many experts believe antipsychotics should only be administered in low to medium doses.
However, according to some studies, medium to higher dosages are more effective.
Below are some typical dose ranges for antipsychotic augmentation, although actual effective dosages can be different.
At high doses, some atypical antipsychotics may worsen OCD symptoms.
Antipsychotic medications also have the potential to cause side effects.
It also increases the risk of akathisia, which leads to restlessness and an inability to be still.
Timeline and Withdrawal
Don’t expect antipsychotics to immediately impact your symptoms of OCD.
You may notice improvements within the first few days of taking these medications.
However, it usually takes several weeks to fully experience their benefits.
Some guidelines recommend you take an antipsychotic for at least one year after symptom remission.
Discontinuing earlier than that may increase your chances of relapse.
Depending on which antipsychotic you’re taking, this can lead to unwanted effects and problems managing your illness.
Get our printable guide to help you ask the right questions at your next doctor’s appointment.
Pittenger C, Bloch MH.Pharmacological treatment of obsessive-compulsive disorder.Psychiatr Clin North Am.
2014;37(3):375391. doi:10.1016/j.psc.2014.05.006
International OCD Foundation.Medications for OCD.
2016;77(5):e605-11.
doi:10.4088/JCP.14r09758
Paxos C.Moving beyond first-line treatment options for OCD.Ment Health Clin.
2022;12(5):300-308. doi:10.9740/mhc.2022.10.300
National Library of Medicine.Clomipramine.
Khan SA.Drug therapy for obsessive-compulsive disorder.US Pharm.
2023;48(5):8-12.
2020;20:372. doi:10.1186/s12888-020-02769-9
Thamby A, Jaisoorya TS.Antipsychotic augmentation in the treatment of obsessive-compulsive disorder.Indian J Psychiatry.
2019;61(Suppl 1):S51-S57.
2024;39(3):e2893.
doi:10.1002/hup.2893
Leung J, Palmer B.Psychosis or obsessions?
Clozapine associated with worsening obsessive-compulsive symptoms.Case Rep Psychiatry.
2016:2180748. doi:10.1155/2016/2180748
Cleveland Clinic.Antipsychotic medications.
Bommarito S, Morris M.The role of antipsychotics in OCD.
Anxiety & Depression Association of America.
2016;39(1):29-39. doi:10.1097/WNF.0000000000000117
