OCD medication
This information is for general guidance only and is not a substitute for personalised medical advice. Always speak to your GP or psychiatrist before starting, changing or stopping any medication.
If you’re thinking about taking medication to help manage obsessive compulsive disorder (OCD), it’s completely natural to have questions – and even concerns. Learning about how OCD medication works and when it’s used can help you take confident, informed steps forward.
This page explains the types of medication used to treat OCD, how they work, what to expect, and how they fit into a long-term treatment plan.
What types of medications are used to treat OCD?
Several medications can help manage OCD symptoms, each working in slightly different ways.
For OCD, medications are often taken at higher doses and for longer periods than when they’re used to treat depression. Your doctor/psychiatrist will be able to explain this and increase your dose gradually and as required.
SSRIs – the most common medication for OCD
Selective serotonin reuptake inhibitors (SSRIs) are usually the first type of medication offered. They increase levels of serotonin – a brain chemical that helps regulate mood and anxiety – and can ease obsessive thoughts and compulsions. Switching between SSRIs is sometimes considered if the first doesn’t help enough or causes side effects.
Common SSRIs prescribed for OCD include (but are not limited to):
Fluoxetine
Often the first choice, helps reduce obsessive thoughts over time
Sertraline
Widely used for OCD and anxiety, suitable for adults and young people
Fluvoxamine
Specifically licensed to treat OCD in the UK, helpful for people with frequent intrusive thoughts
Paroxetine
Sometimes used when other SSRIs haven’t worked
Clomipramine – an alternative if SSRIs don’t work
Clomipramine is a tricyclic antidepressant that boosts serotonin and norepinephrine. It’s effective but can cause more side effects, such as dry mouth, constipation, blurred vision, dizziness and weight changes, so it’s usually offered if SSRIs haven’t helped.
Antipsychotics – sometimes added to support treatment
If symptoms are very severe or haven’t improved with antidepressants alone, a low dose of antipsychotic medication may be added, rather than used on its own. This can help ease distressing thoughts or anxiety. Antipsychotics aren’t usually the first step in treatment, but for some people, they can make a real difference when other approaches haven’t provided enough relief. Examples of such antipsychotic medications are olanzapine, aripiprazole, quetiapine or risperidone.
How do doctors decide which medication to prescribe for OCD?
There’s no one-size-fits-all approach when it comes to OCD medication. What works well for one person might not be the right fit for someone else. That’s why doctors take the time to understand your individual situation before recommending any medication.
When is OCD medication recommended?
Medication is usually offered if:
- Your symptoms are having a significant impact on your daily life
- You haven’t responded fully to therapy alone
- You’re waiting for therapy and need support in the meantime
- A combination of treatment approaches is likely to be most effective for you
Not everyone with OCD chooses to take medication. Some people find that therapy alone is enough, while others benefit most from combining therapy with medication.
What do doctors consider when choosing a medication?
To help find the most suitable option, your doctor or psychiatrist will look at a range of factors, such as:
- The severity of your symptoms – more intense symptoms may call for higher doses or a different treatment approach
- Your treatment history – if you’ve tried medication before, what worked or didn’t work will help guide the next step
- Physical health conditions – certain medications might not be suitable if you have other health concerns, so these are always taken into account
- Your lifestyle – things like sleep patterns, daily routines or other responsibilities may influence which medication is best for you
- Pregnancy – if you’re pregnant, breastfeeding or thinking about having a baby, your doctor will talk through the safest options with you
- Mental health conditions – if you’re experiencing anxiety, depression or another condition, this will be factored into your treatment plan
How does OCD medication work and how long does it take?
SSRIs help rebalance serotonin, making obsessive thoughts and compulsions feel less overwhelming and easier to manage. While they don’t cure OCD, they can make day-to-day life more manageable and support progress in therapy.
Most people start to notice benefits after 4 to 6 weeks. Progress is often gradual – you might not feel an immediate change, but over time, symptoms tend to ease and triggers become easier to handle.
Your doctor will monitor how you’re doing and make adjustments if needed.
What are the side effects of OCD medication?
It’s completely natural to feel unsure or even a little anxious about side effects, especially if you’re new to psychiatric medication.
The good news is that most people who take medication for OCD don’t experience serious side effects, and many find that the benefits outweigh any initial discomfort. Side effects, if they do happen, are usually mild and tend to settle within the first few weeks of treatment.
Common short-term side effects of SSRIs
Like all medications, SSRIs can cause side effects, especially in the early stages as your body adjusts. Common short-term side effects may include:
- Nausea
- Headaches
- Trouble sleeping or vivid dreams
- Feeling anxious or restless
- Sexual side effects (such as reduced libido)
- Changes in appetite or digestion
These side effects usually improve within the first couple of weeks. If they don’t, your doctor may adjust your dose or switch to a different medication.
Rare but serious side effects
In a small number of cases, more serious side effects can occur. These can include:
- Increased anxiety or agitation (usually short-term)
- Suicidal thoughts (especially in people under 25)
- Serotonin syndrome (extremely rare – symptoms include fever, confusion and muscle stiffness)
If you develop symptoms such as high fever, confusion, severe agitation, hallucinations, rapid heartbeat, or muscle stiffness, seek urgent medical help by calling 999 or going to A&E.
If you’re worried about how medication is affecting you – physically or emotionally – speak to your GP or psychiatrist. You won’t be judged, and you won’t be pressured to continue with something that isn’t working for you.
Medication as part of a long-term OCD treatment plan
Medication can play an important role in OCD treatment, but it’s rarely the only approach. Most people benefit from a combination of treatments that are tailored to their individual needs.
How medication and therapy work together
The most effective way to treat OCD often involves a combination of medication and talking therapy. A specific type of cognitive behavioural therapy (CBT), known as exposure and response prevention (ERP), is considered the gold standard. It helps you gradually face the thoughts and situations that trigger your anxiety, without turning to compulsions to cope.
Medication can make it easier to engage with therapy, especially if your symptoms are severe or if anxiety feels overwhelming. Some people use medication as short-term support while they build skills and confidence through therapy. Others find that staying on medication longer term helps them maintain progress and feel more stable day-to-day.
Your treatment plan should always be shaped around what works best for you, and it’s completely normal for that to evolve over time. You might start medication before beginning therapy, or continue taking it after therapy ends. You may eventually feel ready to reduce or stop your medication, or decide that ongoing support is what you need to stay well.
Whatever your path, your GP or psychiatrist will help you explore the best options and adjust things as needed – offering support every step of the way.
Don’t stop medication suddenly
If you're considering stopping your medication, always speak to your doctor first. Coming off medication too quickly can cause withdrawal symptoms such as dizziness, ‘electric shock’ sensations, flu like symptoms, sleep problems or a sudden return of anxiety and OCD symptoms.
A gradual, supported plan gives you the best chance of staying well and feeling in control.
Get help for OCD today
If you're looking for support with OCD, Priory is here to help. Our expert-led services are tailored to your individual needs, whether you're just beginning your journey or looking for ongoing care.
You don’t need to wait until things feel ‘bad enough’ to ask for help. Reaching out early can make treatment more effective and help prevent symptoms from getting worse. Get in touch with us today to find out how we can support you.