Try Our OCD Self-Help Program

Try our OCD Self-Help Course

Still Feeling Anxious? Swipe Up

SSRIs & OCD – Can Antidepressants Really Calm My OCD Symptoms?

Obsessive-compulsive disorder (OCD) is a common anxiety condition that involves reoccurring and involuntary intrusive thoughts and compulsive behaviors (routines or rituals) performed to ease one’s stress and anxiety. Severe OCD can be so debilitating that it can make it extremely hard to have a “normal” life.

More specifically, it can prevent you from holding down a job, caring for your children, spending time with your partner, spouse, or friends, and/or performing household tasks. OCD symptoms are usually treated with cognitive-behavioral therapy (CBT), exposure-response prevention (ERP) therapy, acceptance and commitment therapy (ACT), medication, lifestyle changes, and self-help tools.

Researchers suggest that combining at least two of the approaches above may yield the best results. When medications are used to reduce or alleviate OCD symptoms, antidepressants, specifically SSRIs, are the first-line treatments. SSRIs target serotonin pathways in the brain, which make them highly effective at treating OCD symptoms.

Now that we have a good idea of what OCD is, let’s take an in-depth look at the various SSRIs that have been found to help people suffering from OCD.

So, can antidepressants really “calm” your OCD symptoms? Yes!

Content

Can SSRIs Effectively Treat OCD Symptoms?

Yes, SSRIs can effectively treat OCD symptoms.

Most people will experience at least some OCD relief after taking SSRIs for their symptoms, however, there is a risk of residual symptoms. When this occurs, your primary care physician (PCP) or psychiatrist will likely prescribe other medications for your OCD symptoms. Celexa (citalopram) and Lexapro (escitalopram) are also SSRIs, however, they are not FDA-approved to treat OCD.

When these medications are prescribed for people with OCD, it is described as “off-label” use of the drug. Moreover, researchers have found that Cymbalta (duloxetine) and Effexor (venlafaxine), two serotonin-norepinephrine reuptake inhibitors (SNRIs), may also be used to treat OCD symptoms, especially when combined with SSRIs.

What SSRIs Are Good For OCD?

Antidepressants are usually the first medications used to treat OCD. The most common antidepressants prescribed for OCD are selective-serotonin reuptake inhibitors (SSRIs). Although antidepressants, like SSRIs, are normally used to treat depression, studies suggest that SSRIs can also be extremely effective for OCD. Researchers have found that 70% of people with OCD have received some degree of relief after taking SSRIs for their symptoms.

The following SSRIs are FDA-approved to treat OCD in children and/or adults:

  • Prozac (Fluoxetine)Prozac is an SSRI antidepressant that can boost the amount of serotonin in your brain. Prozac is FDA-approved to treat OCD symptoms in children (over the age of 6) and adults. This SSRI is available in capsule form and delayed-release capsule form.

    It is important to understand, however, that all SSRIs appear to be effective, so one SSRI is no more beneficial than another SSRI when treating OCD. Researchers have found little-to-no difference between Anafranil (clomipramine), a tricyclic antidepressant, and SSRIs (i.e., Prozac, Luvox, Paxil, and Zoloft) in effectiveness.

    Note: SSRIs are typically the first-line medication used to treat OCD symptoms, primarily because they are usually well-tolerated and highly effective.

  • Luvox (Fluvoxamine)Luvox is also an SSRI antidepressant that is FDA-approved to treat OCD in children (over the age of 7) and adults. Luvox is available in pill and extended-release capsule forms. Researchers have found that fluvoxamine, the generic form of Luvox, may be beneficial for people with anxiety conditions, like OCD.
  • Paxil (Paroxetine) – Paxil, another SSRI antidepressant, is FDA-approved to treat OCD symptoms in adults. Paxil is available in tablet and liquid forms. According to a previous study, paroxetine, the generic form of Paxil, is one of several SSRIs, that is highly effective for OCD.

    However, some studies have found that this antidepressant may come with added side effects, such as heightened cancer risks, male infertility, birth defects, gestational hypertension, prolonged QT interval in infants, hyperprolactinemia, cognitive impairment in older adults, autism, sexual issues (i.e., erectile dysfunction (ED), premature ejaculation (PE), etc.), sudden weight gain, suicidal ideation (suicidal thoughts and/or attempts), and/or aggression.

  • Zoloft (sertraline)Zoloft is an SSRI antidepressant that is FDA-approved to treat OCD symptoms in children (over the age of 5) and adults. This SSRI is available in pill and liquid forms. Researchers suggest that sertraline, the generic form of Zoloft, may reduce or alleviate OCD symptoms (obsessions and compulsions) – in some people.

Note: If you do not respond well to SSRIs, your doctor may prescribe Anafranil (clomipramine), a tricyclic antidepressant that is FDA-approved to treat OCD symptoms. However, keep in mind that clomipramine, the generic form of Anafranil, may cause side effects, such as a dry “cotton” mouth, blurred vision, extreme sleepiness, sudden weight gain, and/or an accelerated heart rate.

What is the Typical SSRI Dosage for OCD?

SSRI dosages tend to be higher for OCD than for depression. Therefore, your doctor will likely prescribe a low dose – at least initially. However, he or she may increase the dosage, if the initial dosage appears to be ineffective.

Listed below are the recommended SSRI dosages for OCD:

Medications

Luvox

  • Starting Dose: 50mg
  • Target Dose: 200mg
  • Maximum Dose: 300mg

Paxil

  • Starting Dose: 20mg
  • Target Dose: 40-60mg
  • Maximum Dose: 60mg

Prozac

  • Starting Dose: 20mg
  • Target Dose: 40-60mg
  • Maximum Dose: 80mg

Zoloft

  • Starting Dose: 50mg
  • Target Dose: 200mg
  • Maximum Dose: 200mg

Note: If your OCD symptoms do not improve, at least 40%, after 12 weeks, your doctor may have to adjust your dosage, or prescribe a different OCD medication.

Did you know, our our self-help course has helped thousands of OCD sufferers better manage their symptoms?

"My OCD is finally manageable"

Jennifer S

Do SSRIs Have Any Side Effects?

Yes, as with almost all medications, SSRIs do come with side effects.

SSRIs can produce a host of unpleasant side effects. And, although some side effects may be mild, others may be more serious. Some SSRI side effects may be acute and disappear, while others may become chronic over time. If you experience side effects after taking an SSRI, it is important to request another medication for your OCD symptoms.

If your doctor is unable to prescribe another SSRI for your OCD, he or she may be able to provide you with healthy coping skills and strategies to help you effectively deal with your side effects. Most people experience a reduction in OCD symptoms and SSRI side effects over time (usually within 4 weeks). However, if the side effects worsen and/or persist past the 4 weeks, contact your doctor.

Also let your doctor know if you are pregnant, planning to become pregnant, or are breastfeeding. Although most antidepressants are considered a safe treatment for OCD, there have been incidences in which young children, teens, and young adults have experienced suicidal thoughts and attempts after taking antidepressants for OCD symptoms.

Thus, if you are taking antidepressants for OCD, look for signs of suicidal ideation (thoughts of self-harm, suicidal thoughts, and/or suicidal attempts). If you notice a change in behavior while taking an SSRI, consult your doctor, call 911, or go to the nearest ER.

And, if you decide that your SSRI is not right for you and decide to stop taking it, consult your doctor before you do so. Your doctor will help you safely wean off the medication so you do not experience unpleasant side effects or complications. Keep in mind that you may experience the following SSRI withdrawal symptoms after stopping the medication – i.e., nausea, vomiting, headaches, dizziness, fatigue, body aches, and other flu-like symptoms.

Common Side Effects

Listed below are common side effects linked to SSRIs:

  • Anxiety
  • Blurred Vision
  • Dizziness
  • Dry “Cotton” Mouth
  • Extreme Fatigue
  • Emotional Numbness or Detachment
  • Insomnia or Sleeplessness
  • Nausea, Vomiting, and/or Constipation
  • Increased Hunger and Weight Gain
  • Sexual Issues

Note: A psychologist or therapist can teach you healthy coping skills and strategies to help you deal with your OCD symptoms. He or she may also tweak your SSRI dosage or transition you to another medication – one you can tolerate better.

The good news is the side effects should dissipate once your body adjusts to the medication (usually within a few weeks). However, some people may not experience relief for 6 weeks or more. You can ward off some, if not all side effects by taking your medication(s) with food, increasing your water intake, following a healthy diet, getting plenty of rest, and exercising daily.

Severe Side Effects

Though rare, there are some severe SSRI side effects, you should be aware of, such as:

  • Serotonin Syndrome

    Serotonin syndrome is a life-threatening condition that occurs when serotonin, a hormone/neurotransmitter or chemical messenger in your brain, reaches extremely high levels. Serotonin syndrome symptoms may include mental confusion, nervousness, twitchy muscles, excessive perspiration, jitters, and/or diarrhea. In severe cases, serotonin syndrome may involve dangerously high fevers, convulsions, irregular heartbeats, and/or coma.

    Note: Serotonin syndrome typically occurs when you combine SSRIs with other antidepressants (i.e., SNRIs) that affect your serotonin levels.

  • Hyponatremia

    Hyponatremia, an electrolyte abnormality, occurs when your sodium (salt) levels rapidly decline until they are dangerously low (less than 135mEq/L), causing large amounts of fluid to accumulate in your body. Salt is an electrolyte that helps control how much water you have in your body. SSRIs can negatively affect your hormone levels, altering the amount of sodium and fluid in your body.

    Note: Studies suggest that older people with OCD may be especially vulnerable to developing hyponatremia.

    Mild cases of hyponatremia can cause the following symptoms:

    • Mental Confusion
    • A General Feeling of Being Ill
    • Headaches or Migraines
    • A Loss of Appetite and Weight Loss
    • Muscle Cramps
    • General Aches and Pains

    In the most severe cases, you may also experience restlessness, fatigue, disorientation, hallucinations, delusions, depression, agitation, anxiety, psychosis, and/or seizures. Keep in mind that hyponatremia can lead to coma or death if it is not promptly addressed. However, you should still contact your doctor even if you are only experiencing mild symptoms.

  • Suicidal Ideation

    Suicidal ideation, also referred to as suicidal thoughts and attempts, is a serious, life-threatening side effect of SSRIs. Suicidal ideation usually arises fairly quickly after starting one or more SSRIs or antidepressants. In the beginning, SSRIs may worsen your OCD symptoms, causing thoughts of self-harm. Studies suggest that people with OCD, under the age of 25, are especially vulnerable to suicidal ideation.

  • Allergic Reactions

    SSRI allergic reactions can occur if you happen to be allergic to one or more of the active ingredients in the medication. Or, if you are allergic to one or more of the dyes, fillers, or preservatives present in the tablet, capsule, or liquid. Symptoms of an allergic reaction may include facial or throat swelling or edema, an itchy rash, hives, blisters, and/or breathing difficulties. Keep in mind that a serious allergic reaction can become life-threatening if it blocks your airway.

  • Mania

    SSRIs can trigger mania – in some people with OCD, especially if they are not using a mood-stabilizer, like lithium, carbamazepine, divalproex, or lamotrigine. Symptoms of mania can include an overabundance of energy, continuous movement, insomnia or sleeplessness, racing thoughts, impulsive behaviors, exaggerated thoughts and behaviors, an elevated mood, crossness, and/or rapid speech. Although mania is not inherently life-threatening, it still requires treatment.

  • Seizures

    Some antidepressants can cause seizures or electrical brain activity disruptions – even in people, who never had them before. Researchers have found that SSRIs, like fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft), can lead to seizures in some people with OCD – although this is rare (about 0.3%).

    Seizures can involve jerky arm and leg movements, grogginess, mental confusion, unusual sensations, and/or coma or a loss of consciousness. Regardless of the cause, it is important to consult your doctor or call 911, if you experience a seizure.

When Should I Call My Doctor About My SSRI Side Effects?

Understand that it is never a good idea to abandon your SSRI antidepressant without first discussing it with your doctor. Suddenly stopping your medication can lead to Discontinuation Syndrome.

Symptoms of Discontinuation Syndrome include:

  • Agitation
  • Anxiety
  • Depression or Low Mood
  • Blurred Vision
  • Electrical-Shock Sensations
  • Extreme Fatigue
  • Hallucinations and/or Delusions
  • Insomnia or Sleeplessness
  • Irritability or Mood Swings
  • Muscle Pain
  • Dizziness
  • Motor Ataxia (Muscle Coordination Issues)
  • Paresthesia (Skin Tingling or Prickling)
  • Numbness
  • Sluggishness
  • Headaches/Migraines
  • Tremors
  • Profuse Perspiration (Excessive Sweating)
  • Anorexia
  • Nightmares, Night Terrors, or Vivid Dreams
  • Gastrointestinal Distress (Nausea, Constipation, Upset Stomach, Abdominal Pain, Vomiting, and/or Diarrhea)

Note: If you feel as if your prescribed SSRI is not working or is causing significant side effects, contact your doctor as soon as possible. Your doctor may add another medication to your treatment plan to ease your side effects or replace it altogether. If he or she decides to stop and/or replace the SSRI, you will likely be instructed to wean off of the previous medication. The purpose of the “weaning process” is to avoid SSRI withdrawal symptoms and lower your risk of an OCD relapse.

What Else Can Help Me with My OCD Symptoms?

Well, lifestyle changes, like eating healthy foods, getting proper sleep, and regular exercise, along with self-help tools, like an online OCD treatment program, can help you get a handle on your OCD symptoms. Online OCD treatment programs, like Impulse Therapy, can help you better understand the ins and outs of OCD, so you can receive the proper treatment for it. Even better? Impulse Therapy’s OCD assessment can help you determine if you have OCD while offering you guidance and support. And, guess what? You can use it while taking SSRIs for your OCD! With Impulse Therapy’s help, you can kick your OCD symptoms to the curb!

Our self-help OCD therapy course has helped 1000s of OCD sufferers since 2018.

"My OCD is finally manageable"

Jennifer S

Author

DR. R. Y. Langham

Dr. R. Y. Langham has a B.A. in English, an M.M.F.T in Marriage and Family Therapy (Psychology), and a Ph.D. in Family Psychology. She is currently a medical, health & wellness contributor, copywriter, and psychological consultant

Share Post