Does Sertraline (Zoloft) Work for OCD?

Life with OCD is tough — but thankfully, there are many treatment options out there to help you find recovery. One of the most commonly prescribed treatments is the medication sertraline, more commonly known as Zoloft. Here’s your guide on everything you need to know about this antidepressant and whether it might be able to help you with your OCD symptoms.

Zoloft is the U.S. brand name for an antidepressant medication called sertraline, which is classified as a Selective Serotonin Reuptake Inhibitor (or SSRI). Other common brand names that sertraline is sold under in Europe and the UK include Lustral, Serlain, and Tresleen. 

Sertraline is mostly used in the treatment of clinical depression, but as we’ll learn later on, it’s used effectively for many other conditions as well — including OCD.

How SSRIs Affect the Brain

Sertraline (or Zoloft) is far from the only SSRI on the market. Other brand names for different drugs in the SSRI category include Prozac, Luvox, Paxil, and Lexapro.

Mental health disorders like depression and OCD are neurological illnesses, meaning that they cause our brains to dysfunction. One of the ways that these disorders change our brains is through changing the patterns of release and reuptake of certain neurotransmitters.

One neurotransmitter, serotonin, sends messages between neurons in regions of the brain that are responsible for mood. SSRIs limit the reabsorption of serotonin into the neurons, which then increases the overall levels of serotonin in the brain. When there is enough serotonin available in the brain, it starts working properly again — in other words, the symptoms of the mental illness get better.

The History of Sertraline (Zoloft)

Back in the 1970s, a chemist working at the multinational pharmaceutical corporation Pfizer Inc. created a new chemical compound called lometraline, which used to be prescribed as an antipsychotic medication. A few years later, another chemist studied that compound and discovered that one of its derivatives was a serotonin reuptake inhibitor. The company ended up patenting the most potent derivative as sertraline. In short, the discovery of Zoloft was somewhat of a happy accident.

After enough clinical trials were conducted, Zoloft became available in the U.K. in 1990; the U.S. Federal Drug Administration (FDA) approved it the following year. Pfizer’s U.S. Zoloft patent expired in 2006, and since then, sertraline has become available in generic form.

What is Zoloft Used For?

Zoloft, along with most other SSRIs, is used primarily to treat major depressive disorder. However, it’s also been approved to treat obsessive-compulsive disorder, panic disorder, premenstrual dysphoric disorder, post-traumatic stress disorder, and social anxiety disorder.

Sertraline for Depression

Sertraline is used to treat depression in adults over the age of 18; this is the main mental illness for which this medication is prescribed. There’s been no benefit found for depressed teens and children (although Zoloft does help teens and children with other mental health disorders, which we’ll talk about later). The effectiveness of Zoloft to treat major depressive symptoms is about the same as other antidepressant medications. 

Many people choose to take sertraline for depression because it tends to have fewer side effects than older antidepressant types.

Sertraline for OCD

Sertraline is approved for treating OCD symptoms in both adults and children. In fact, for kids under the age of 18, sertraline is only approved to be taken as treatment for OCD (not for depression). We’ll go over more detailed information about the benefits of Zoloft for OCD in the next section.

Sertraline for Panic Disorder

Studies have found that Zoloft decreases the prevalence of panic attacks for people with panic disorder by up to 80 percent. Even a placebo drug, however, decreased panic attacks by 40 percent; this means that sertraline decreases panic attacks by about half compared to placebo.

As an important side note, sertraline has been found to be effective for people with panic disorder whether or not they also suffer from agoraphobia.

Sertraline for Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder, or PMDD, is diagnosed when people with female reproductive organs experience symptoms of depression only at certain times in their menstrual cycle. Symptoms of this PMDD are very similar to major depressive disorder, so it makes sense that sertraline would be effective for this condition.

Sertraline for PTSD

Relatively recently, psychiatrists have started to use Zoloft in the treatment of PTSD. A 2000 study found that sertraline helps PTSD sufferers to find relief from their symptoms; in the same year, sertraline was approved by the FDA as the first-line pharmacological treatment for PTSD.

Although behavioral interventions for PTSD are highly effective as well, sertraline is often used for people with PTSD who prefer to take medication over going to therapy.

Sertraline for Social Anxiety and Other Anxiety Disorders

Sertraline has only been approved for the treatment of social anxiety disorder, but studies have shown that there may be benefits for a whole array of anxiety disorders. Common symptoms of anxiety disorders, like fear, avoidance, and psychosomatic symptoms all respond well to sertraline.

Side Effects of Zoloft

In general, sertraline causes less side effects than other, older types of antidepressants. However, that doesn’t mean that there are no side effects whatsoever. Common mild side effects when taking sertraline include:

• Nausea, constipation, or diarrhea
• Dizziness
• Dry mouth
• Exhaustion, fatigue, or weakness
• Drowsiness
• Headaches
• Insomnia and other sleep problems
• Changes in sex drive or ejaculation
• Temporary increased anxiety

These side effects usually go away after your body adjusts to the medication, but you should tell your doctor about any side effects that you’re facing.

In addition to these common side effects, there is a possibility of more serious side effects when taking sertraline. These serious side effects are rare — around a 1 in 100 risk or less — but it’s still important to be aware of them. If you experience any of these side effects, then you need to call your doctor or go to an emergency room right away:

• Increase in suicidal thoughts
• Stiff muscles
• High fever
• Hallucinations, mental confusion, tremors, losing your balance, or feeling like you’re going to pass out
• Nausea and vomiting, especially if your vomit is bloody or dark
• Feeling restless or euphoric, or having racing thoughts
• Bleeding from your gums for no reason

As with any medication or ingested substance, serious allergic reaction (anaphylaxis) is also possible, but rare.

Who Shouldn’t Take Zoloft?

Talk to your medical provider about whether or not you might be a good candidate to take sertraline. This drug is generally safe and well-tolerated, but it might carry extra risks for some people. Particularly if you fall under the following categories of people, make sure you let your doctor know about your symptoms and conditions. Check with them to make sure it’s safe to start taking Zoloft.

Pregnant or Breastfeeding People

If you’re pregnant, planning to become pregnant, or breastfeeding, you should talk to your doctor about whether or not to take sertraline during your pregnancy. Your doctor will weigh the medication’s benefits against its risks to help you make a decision. Severe OCD symptoms can sometimes be more risky and damaging for pregnant women than sertraline is.

People with Bipolar Disorder

If you’ve been diagnosed with bipolar disorder or have experienced a manic or hypomanic episode, any antidepressant could increase your chance of mania. That doesn’t mean that you can’t take sertraline, but always be honest with your doctor about your symptoms.

People with Heart Problems

SSRIs can speed up or change your heart rate, so people with heart problems should check with their doctor before starting sertraline treatment.

People with Glaucoma

All SSRIs can increase eye pressure, so if you have glaucoma or if you’re at risk for it, let your psychiatrist know.

People with Seizure Disorders

If you have epilepsy or other types of seizures (for example, if you’re receiving electroconvulsive therapy), let your doctor know — a heightened risk of seizures is a rare but serious side effect of sertraline.

Even if you have been diagnosed with one of these conditions, that doesn’t automatically disqualify you for sertraline treatment. Talk to your psychiatrist or medical provider to figure out together whether or not sertraline might be a good fit for your specific situation.

Sertraline (Zoloft) and OCD

Does Sertraline Work for OCD?

Sertraline, or Zoloft, is one of the most common medications that is used to treat OCD. Earlier in the history of OCD treatment, an older type of antidepressant medication called Anafranil was commonly prescribed for OCD. Anafranil (which is a serotonin reuptake inhibitor, not a selective serotonin reuptake inhibitor) can come with some nasty side effects, which has led physicians to start prescribing SSRIs like sertraline for OCD instead.

SSRIs like sertraline, like we discussed before, affect the way our brains work. Specifically, it increases the amount of serotonin in the brain. This is what is thought to improve both OCD symptoms as well as symptoms of mood and anxiety disorders.

Sertraline has been found to be very effective in treating OCD symptoms in both adults and children. Medications like sertraline have been found to reduce OCD symptoms by about half. In fact, SSRIs like sertraline have been found to be equally effective as Anafranil, but with less side effects. Sertraline, or any medication, is most effective for OCD when taken in conjunction with receiving a type of therapy like Exposure and Response Prevention.

The FDA has approved the use of sertraline, along with 4 other SSRIs, for the treatment of OCD in the United States; it’s approved and available in the U.K. as well.

Sertraline for OCD-Related Depression

It’s also important to consider OCD’s high comorbidity rate with depression. Over half of people with OCD also experience symptoms of depression. For anyone living with OCD, this won’t come as a surprise to you; living with intrusive thoughts and the constant urge to perform compulsions, day after day, wears you down after a while. It’s no shock that depression follows soon after.

This may be another reason why sertraline and other SSRI medications are so effective for the treatment of OCD. Like we talked about above, the medication is effective for specifically treating OCD symptoms like intrusive thoughts and fear. But it’s also effective for treating depression; studies have consistently found that sertraline is a safe and effective antidepressant drug.

If you suffer from co-occurring OCD and depression, sertraline might be able to help you find relief from both.

Frequently Asked Questions About Sertraline and OCD

We at Impulse Therapy understand it’s scary to start a new treatment or medication — but being equipped with information can help. Here is some information about the most frequently asked questions about sertraline and OCD. Keep in mind that this blog isn’t intended to replace medical advice, and you should talk over any concerns or questions you have with your medical provider.

Q: Will I experience side effects with sertraline (Zoloft)?

A: Unfortunately, whether or not someone experiences side effects with any medication depends on each person. There are many common but mild side effects associated with sertraline, along with some rare, serious ones. Many people who take sertraline will experience at least one of the side effects that we listed above.

If there’s a specific side effect you’re worried about, talk to your doctor. There are certain things you shouldn’t do because they’ll increase your risk of side effects; for example, don’t take herbal depression remedies like St. John’s Wort while you’re taking sertraline.

Your OCD thoughts may be worrying about whether or not you will experience side effects with this or any other medication, and that’s a typical symptom of the disease. Unfortunately, neither this blog or any other can tell you with absolute certainty whether or not you will experience side effects.

Q: How long does Zoloft take to work for OCD?

A: Typically, people start seeing results within 4 to 6 weeks of starting to take sertraline.

Q: Which is better for OCD: Prozac or Zoloft?

A: Both Prozac (fluoxetine) and Zoloft (sertraline) are different types of SSRI antidepressants, which mean they affect the brain in the same ways. Studies have shown that most SSRIs, including Prozac and Zoloft, have a similar level of effectiveness for both depression and OCD. In short, whether Prozac or Zoloft is better for you will depend on your specific situation. Talk to your doctor to figure out which to start with.

Q: Can Zoloft cause bad thoughts?

A: An increase in suicidal thoughts is a rare but serious side effect of any SSRI medication, including sertraline. The risk, although still small, is higher for people under the age of 25. This can be understandably scary for someone with OCD, especially suicide OCD, who already worries about having suicidal thoughts come on out of nowhere.

Talk to your doctor or therapist about these concerns. We can not provide you with reassurance here that you definitely, one-hundred percent won’t experience this side effect, because reassurance only makes OCD worse. Some ERP exercises around this intrusive thought may also be helpful.

Q: Will Zoloft stop obsessive thoughts?

Yes, sertraline has been shown to reduce obsessive thoughts and the associated fear and anxiety for people with OCD. It’s generally prescribed for adults with OCD, but it’s also approved to treat children and adolescents with OCD as well.

Other SSRI Medications

Sertraline is about as effective for OCD as other types of SSRI antidepressants — no better or worse. And there’s more good news: many people find that even though they aren’t able to tolerate one SSRI (like sertraline, for example), they are able to tolerate other kinds with no side effects. That means that even if sertraline wasn’t for you, other SSRIs might still be.

The other SSRIs that are approved to treat OCD include fluoxetine (Prozac), fluvoxamine (Luvox), and paroxetine (Paxil). Paroxetine is the only one of the 4 medications that is not FDA-approved to be used with children with OCD.

Serotonin Reuptake Inhibitors (SRIs)

An antidepressant medication called Anafranil has been found to be one of the most effective treatments for OCD. However, this medication belongs to an older category of antidepressants called SRIs (as opposed to SSRIs, which we discussed above) that has been known to cause more serious side effects. Many people still find great relief from their OCD symptoms from Anafranil despite these risks.

Off-Label Antidepressants

“Off-label” means that although the medication hasn’t been approved by the FDA to specifically treat OCD, it’s commonly prescribed because there is research that says it could be beneficial. 

Off-label medications that are often prescribed for OCD include SSRIs citalopram (Celexa) and escitalopram (Lexapro), as well as SNRIs (Serotonin-norepinephrine reuptake inhibitors) venlafaxine (Effexor) and duloxetine (Cymbalta). These are usually only prescribed if first-line SSRIs haven’t worked, have caused too many side effects, or can’t be prescribed for any reason.

Cognitive Behavioral Therapy

Any medication treatment is most effective when received alongside a type of psychotherapy called cognitive behavioral therapy or CBT. Specifically, the type of CBT that’s been shown to be the most effective for OCD symptoms is called Exposure and Response Prevention, or ERP.

ERP helps people with OCD to intentionally expose themselves to upsetting thoughts, instead of pushing them away like they usually do. With the help of the therapist, they learn to just sit with the anxiety that the obsession causes without engaging in compulsions.

This is extremely difficult, painful, and terrifying at first — but slowly, the OCD brain starts learning that it doesn’t need to react to every single intrusive thought. The thoughts remain in the back of the mind, but they start to cause less fear, and the person starts gaining their life back.

ERP has been found to be one of the most effective treatments available for OCD, even including medication regimens.

Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation, or TMS therapy, is an innovative new treatment technique that’s being used to help lessen symptoms of OCD. Research has shown that it is effective for both treatment-resistant depression and OCD. TMS therapy uses magnetic coils placed on the scalp to deliver targeted electromagnetic pulses to certain brain regions. This is thought to stimulate the parts of the brain that are most affected by OCD.

TMS therapy usually isn’t a first-line treatment for OCD, but it can be used if you’ve tried ERP and various medications and have found they haven’t worked for you.

Learning About OCD

Spending some time learning about the ins and outs of OCD and what’s causing the symptoms that you’re experiencing can go a long way. Psychoeducation won’t cure you of your OCD, but it can make your OCD journey a lot less scary.

In our Impulse Therapy audio program, we take the time to explain what’s behind the terrifying feelings you’re experiencing. Then, we guide you through CBT exercises that will help you start to learn how to better manage these feelings. You’re not “crazy”, and you’re not alone. Millions of people suffer with OCD around the world, and recovery is possible with the right treatment.