Obsessive-compulsive disorder (OCD) is a mental illness characterized by repeated thoughts or actions that interfere with normal life. It is classified in the psychiatric literature as an anxiety disorder, according to Emedicine.com. The most commonly used medications to treat OCD affect the brain chemical serotonin. Several drugs are approved by the U.S. Food and Drug Administration for use in OCD therapy, but sometimes alternative drugs are used as well.
FDA-approved Drugs
The Mayo Clinic cites a handful of drugs that have received an FDA indication for treating OCD. Clomipramine was the first drug found to be effective for OCD in clinical trials, states Stanford School of Medicine. It is in a group of drugs known as tricyclic antidepressants. Due to side effects, which include dry mouth, stomach upset, and dizziness, it is not usually chosen first to treat OCD.
Fluvoxamine, fluoxetine, paroxetine and sertraline are drugs in the selective serotonin reuptake inhibitor (SSRI) class. These medications are typically better tolerated than clomipramine and are equally effective. About half of patients will respond to one of these drugs, but it may take up to three months. If ineffective, there are other options. Fatigue, sexual dysfunction and gastrointestinal upset are some of the more common SSRI side effects.
Non-FDA-approved Drugs
Off-label use of drugs is legal and common. A prescriber may use her discretion; many drugs can be effective treatments for OCD, yet not have an FDA indication. Such is the case with venlafaxine, a drug that acts on the brain chemicals serotonin and norepinephrine. Venlafaxine may elevate blood pressure or cause headache or dizziness. Other SSRIs such as citalopram and escitalopram fall under this category as well.
Combination Therapy
Using more than one drug at a time may increase the effectiveness of OCD treatment. Buspirone, clonazepam and trazodone are medications used to treat other forms of anxiety, and may be useful when combined with an SSRI. These drugs could cause fatigue and some caution needs to be exercised with the combination. Sometimes the addition of an antipsychotic medication such as haloperidol, olanzapine or risperidone can be helpful, notes the Stanford School of Medicine. These medications can cause dizziness and sedation. Desipramine is another antidepressant drug that affects norepinephrine and its addition to standard therapy is discussed on Emedicine.com. Desipramine is known to sometimes lead to drowsiness, nausea or headache. Drug combination therapy should only be tried under the direction of a physician.
