How Do OCD Medications Work?
Published January 30th, 2025
5.5 min read
OCD medications affect neurochemicals in the brain, effectively treating symptoms when combined with therapy.
Written by Simon Spichak
Medications, especially when combined with therapy, are an effective means for treating the symptoms of obsessive-compulsive disorder (OCD). These medications prolong the effects of chemical signals in the brain. They need to be taken regularly to see the benefits.
What is OCD?
OCD is a mental health condition that affects one in every 40 people worldwide. There are two main components to OCD — obsessions and compulsions. Obsessions are unwanted thoughts and desires that cause extreme distress, shame, or anxiety. Compulsions are repetitive thoughts, behaviours, or actions that relieve negative feelings.
What kinds of medications work for OCD
Drugs commonly used to treat depression, called selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are also prescribed to treat OCD.
Though we don’t know precisely how these drugs' actions at the neurochemical level lead to improvements in symptoms, we do have some clues as to how they work. These medications prolong the activity of a neurochemical called serotonin or norepinephrine in the brain but also affect the bacteria in the gut microbiome, influence different circuits and changing the size of various brain regions.
SSRIs and SNRIs prescribed for OCD
Not all SSRIs and SNRIs that are effective for depression work for OCD. In particular, doctors will prescribe:
Fluvoxamine (Brand name: Luvox®)
Fluoxetine (Brand name: Prozac®)
Sertraline (Brand name: Zoloft®)
Paroxetine (Brand name: Paxil®)
Citalopram (Brand name: Celexa®)*
Clomipramine (Brand name: Anafranil®)
Escitalopram (Brand name: Lexapro®)
Venlafaxine (Brand name: Effexor®)
For OCD, a high dose of these drugs is needed to see a benefit. It takes time to titrate up the dose as the drugs come with side effects. It may take three months before your doctor knows if a drug is working.
For some people, one drug won’t work while another does. Scientists aren’t exactly sure why.
Some people might be prescribed a drug called an atypical antipsychotic, such as risperidone (Brand name: Risperdal®), aripiprazole (Brand name: Ablify®), or quetiapine (Brand name: Seroquel®). These drugs influence dopamine in the brain and may help if an SSRI or SNRI alone doesn’t work.
Common side effects of OCD medications
Most people who take these medications will experience side effects. You and your doctor or psychiatrist must weigh whether the benefits outweigh them. Don’t stop taking the medications on your own. Consult with a medical professional who can help you taper off of them safely.
Common side effects include:
Sleep problems
Sexual dysfunction and lowered libido
Changes in appetite or weight
Dizziness
Anxiety
Dry mouth
Headache
Stomach problems
Vision problems
Increased heart rate
In rare cases, this class of drugs might make people feel suicidal.
Are OCD medications safe during pregnancy?
SSRIs, which are often prescribed for OCD, are linked to premature delivery, lower birth weight, and other syndromes. However, poor mental health also affects brain development, so it is up to you and your psychiatrist to decide whether the risks are worth it. Some SSRIs may be less risky during pregnancy than others.
Tips for taking OCD medications
Make sure to take your medications every day, not just when you’re feeling a flare-up of symptoms.
In addition:
Set an alarm or reminder to ensure you take your medications at the same time every day.
Keep a journal of side effects and symptoms to track your progress.
Be aware that OCD medications may make you more vulnerable to heat stroke. Take precautions, hydrate, and stay out of the sun on hot days.
Don’t stop taking the medication without consulting your doctor or psychiatrist.
Combining medications with therapy
Fewer than one in five people treated with medications alone will see a complete recovery from their symptoms. However, combining these medications with the frontline treatment for OCD, exposure and response prevention (ERP) therapy, can lead to sustained and lasting improvements.
ERP works by progressively exposing you to distressing situations that trigger your obsessions while preventing you from acting out the compulsions. The treatment is personalized based on your OCD symptoms.
It helps rewire the brain, helping it become desensitized to obsessive thoughts – making it easier for you to feel relief and lower your anxiety without having to perform the compulsions.
You can read more about OCD here:
How Resolvve Can Help
Resolvve’s therapists are trained to treat OCD and can help reduce your symptoms. If you’re ready to take the next step toward treatment, you can book a free consultation with one of our therapists. For many college and university students, the entire cost of the therapy session may be covered by your student insurance.
Please note that this post is written for educational purposes; it is not therapy. If you need to talk to a professional, please book a consultation with a psychotherapist through Resolvve.
