How effective are SSRIs for OCD treatment? An overview

You may have heard about selective serotonin reuptake inhibitors (SSRIs), a class of medications most often used to treat depression as well as a few other mental health conditions, and wondered what they can and can’t effectively treat.

As the Chief Clinical Officer for NOCD, a leader in the treatment of obsessive-compulsive disorder (OCD), I know that SSRIs are something that many patients have questions about. Although medication is not recommended as an initial treatment method for most people with OCD, medication is often a very important part of someone’s treatment plan.

Let’s dig into some of the most common questions so you or a loved one can make an informed decision about your health.

What are SSRIs?

There’s a very good chance you’ve heard some names of selective serotonin reuptake inhibitors, such as Prozac, Zoloft, Paxil, and Lexapro, to name a few. These drugs, most commonly used for major depressive disorder, were introduced in the late 1980s. It didn’t take long for SSRIs to become the most commonly prescribed antidepressant medications, as total antidepressant use rose by 64% in the US from 1999-2014. As of 2017, 12.7% of Americans over age 12 were taking these antidepressants.

Although most SSRI prescriptions are still written for depression, these medications are now used for a much wider range of issues. They’re now prescribed for OCD, generalized anxiety, panic disorder, specific phobias, PTSD, and a number of other mental health conditions. It’s important to note that many experts say they’re being prescribed too often—especially by primary care physicians who may not perform a detailed assessment of the patient first. But SSRIs are highly effective for many people with anxiety-related disorders.

When prescribed SSRIs for OCD, about 40-60% of people experience partial reduction in theyr symptoms. SSRIs can be used as a standalone treatment on their own or as a complement to behavioral therapies (like exposure and response prevention). In some cases, SSRIs are even paired with other drugs that affect the brain like atypical antipsychotic medicines (such as aripiprazole), which are sometimes used to treat severe OCD, especially in those experiencing paranoia and/or psychosis. 

So how do SSRIs work?

Serotonin is a brain chemical. It first circulates in the brain and then absorbs into the bloodstream. It’s been called the “feel-good chemical” because serotonin deficiency can lead to depression, anxiety, and other mood issues. SSRIs work by preventing your blood from absorbing some of the serotonin from your brain, leaving higher levels of serotonin available for your brain to use. 

While we know that brain chemicals like serotonin are somehow involved in OCD, but that it’s not simply a matter of serotonin deficiency. We also know that SSRIs can affect the brain in multiple ways, but research has not unlocked all the answers yet. In other words, we do not know exactly why SSRIs are helpful for some people with OCD. That said, some people who take SSRIs show a reduction in the severity of their OCD symptoms. 

Possible side effects of SSRIs

As with all medications, side effects are possible with SSRIs. Of course, it’s possible to take SSRIs and not experience any side effects. Some of the most common side effects of SSRIs tend to include:

• dry mouth
• insomnia
• reduced sex drive
• nausea
• dizziness
• fatigue
• diarrhea
• constipation
• decreased appetite
• Withdrawal symptoms if stopped abruptly

Is it worth trying an SSRI for OCD?

If you think an SSRI might be a good option for you, the best next course of action should be to make an appointment to talk to a professional who has specialized training and experience in OCD treatment. If you’re working with a medical professional who recommends an SSRI and you feel comfortable with possible side effects, it may be worth trying one out. They may alleviate some symptoms of depression, OCD, and other conditions.

At NOCD, our clinicians are very well trained in OCD and can help you find the best treatment plan, whether that’s with a specific kind of therapy called ERP (exposure and response prevention) or a mix of therapy and medication. Our therapists regularly refer NOCD Therapy members for medication management, and coordinate their care with prescribers to make sure you’re on the road to recovery.

In fact, a form of therapy that was designed for OCD specifically—ERP—has equally high success rates without the side effects. Depending on your individual needs and preferences, working with an OCD-trained therapist and trying ERP with or without medication can bring you the much-needed relief you’re looking for.