What Role Do Medications Play in Treating OCD?
Obsessive compulsive disorder (OCD) is an anxiety type disorder; it is a specific and severe anxiety problem characterized particularly by upsetting recurrent unwanted thoughts or obsessions that keep popping into your head even when you don’t want them to and link to the urge to carry out repetitive behaviors (compulsions). While we don’t have a perfect understanding of the causes of OCD, we do know that it’s partially genetic.
There are two main stages to treatment. There is cognitive behavioral psychotherapy (CBT), and there are also medications that can work for OCD. CBT focuses on exposing patients to emotional triggers and helping them interpret and re-evaluate their obsessions. It can work very well but requires time, effort, and commitment from both the patient and therapist. Success depends on the patient’s willingness to work hard and tolerate some anxiety during the process.
Using medication to treat OCD is another conversation. Medication can help 60% of people suffering from OCD but it isn’t a fix for everyone. When a patient uses medication to treat OCD, he/she might experience some side effects. The side effects usually aren’t so bad, but they exist.1 The medications to treat OCD increase the serotonin levels in your brain, thus reducing the OCD symptoms.
Note: This article is for informational purposes only. Please consult a medical professional for any medication or medical needs.
What Are Commonly Prescribed OCD Medications?
Severe OCD typically cannot be treated by psychological therapy alone, so the next option is utilizing medication.
SSRIs, a type of antidepressant, are the most common medication used to treat OCD. They help reduce OCD symptoms and anxiety by lowering serotonin levels, a neurotransmitter that plays a vital role in regulating mood.
The effects of SSRIs can’t be seen instantly, and it may take up to 12 weeks to notice
any change or benefit from using them. The duration of the treatment depends upon how severe your OCD is, but it typically lasts a whole year — as I previously mentioned, it depends upon your symptoms. Some people might need to continue on the medication for several years, and some might recover after using the medication for a year, and then they can stop taking it.
SSRIs work by stopping the nerve cells from reabsorbing the serotonin. You shouldn’t start taking SSRIs without consulting the doctor on your own. If you are taking them, then don’t stop taking them unless your doctor tells you to do so.If you suddenly stop taking SSRIs, you may experience some unpleasant side effects. A doctor will help you gradually reduce the dosage so that there is less chance of experiencing side effects from the medication.
SSRIs are typically used to treat one of the following:
- OCD
- GAD (Generalized anxiety disorder)
- Severe phobias, such as agoraphobia or social phobia
- PTSD (post traumatic stress disorder)
Commonly used SSRIs medicines include:
- Clomipramine (Anafranil)
- Fluoxetine (Prozac)
- Fluvoxamine
- Paroxetine (Paxil, Pexeva)
- Sertraline (Zoloft)2
What Are the Side Effects, Safety Concerns, FDA Warnings, Risks of Drug Abuse, Withdrawal, Interactions, and Overdose?
Possible side effects of SSRIs:
- Low sex drive
- Headaches
- Feeling sick
- Insomnia
- Feeling anxious
- Constipation or diarrhea
- Dizziness
Using SSRIs regularly for a long time can increase the probability of a person having suicidal thoughts or wanting to self-harm. Since it is a type of antidepressant, the FDA requires it to have a black Boxed Warning. When you suddenly stop taking a SSRI medication, you might experience depression, fatigue, nausea, or other side effects. Overdosing on SSRIs is very rare, since a dose higher than 520 mg is required to be lethal. The normal dose is 20-80 mg. It is not recommended to use SSRIs if you are pregnant, especially during the first 3 months of the pregnancy. If you are using it, then the baby might be at risk.3
What Are the Alternative Treatments to OCD Medications?
Psychological Therapy
As mentioned before, CBT is a type of psychotherapy that has proven to be effective for people suffering from OCD. ERP (exposure and response prevention) is one of the components of CBT. It works by exposing the person with OCD to what he/she calls a feared object or obsession, such as dirt, and then they learn how to resist those compulsive urges. ERP is a lengthy process; it takes time and effort. However, it doesn’t have any side effects like medications. Once you learn how to resist your compulsions and how to manage your obsessions, you will start living a better life.
A better way to start the ERP process is by facing the situation or thoughts that give you the least anxiety, then slowly making your way up to the more difficult thoughts. Psychotherapy isn’t an easy process and may sound very difficult to undergo. But many people have gone through this and confronted their obsessions, and as a result experienced a reduction or elimination in their anxiety levels.
Intensive Outpatient and Residential Treatment Programs
These outpatient and residential programs are comprehensive and emphasize ERP therapy principles. They might be helpful to people who suffer from extreme OCD symptoms, and treatments of this nature typically last for several weeks. This treatment is for patients who can’t function because of their symptoms.
Home Remedies
You can practice what you learn from the treatment at home; taking your medications regularly and on time is also important, as well as resisting the urge to skip medications. You should learn certain skills to help you reduce the OCD symptoms and practice them regularly. Try doing yoga and mental exercises to help reduce stress and get more control of your mind. OCD support groups are also available; you can join those, and you might find them very helpful.
What Is Right for You?
It can be tricky to determine which medication is right for you; the goal is to find the medication which works best for you and helps you reduce your symptoms while not generating any side effects. A drug that can prove effective while taking the lowest dosage should be considered. Trying different drugs is normal in order to find out which drug or treatment suits you best. It can also depend on your doctor, as they may recommend more than one medication or treatment. You won’t feel a difference or reduction in your symptoms overnight; it’s a lengthy process that might take weeks to months.4
REFERENCES:
1. OCD – Treatment – NHS [Internet]. [cited 2020 Nov 4]. Available from: https://www.nhs.uk/conditions/obsessive-compulsive-disorder-ocd/treatment/
2. Obsessive-compulsive disorder (OCD) – Diagnosis and treatment – Mayo Clinic [Internet]. [cited 2020 Nov 4]. Available from: https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/drc-20354438
3. Selective serotonin reuptake inhibitors (SSRIs) [Internet]. nhs.uk. 2017 [cited 2020 Nov 4]. Available from: https://www.nhs.uk/conditions/ssri-antidepressants/ 4. Obsessive-compulsive disorder: MedlinePlus Medical Encyclopedia [Internet]. [cited 2020 Nov 4]. Available from: https://medlineplus.gov/ency/article/000929.html
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