Should I take medicines to treat obsessive-compulsive disorder (OCD)?
Introduction
This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.
Key points in making your decision
Obsessive-compulsive disorder (OCD) is a chronic or long-term illness. Without treatment, symptoms typically come and go over time and may significantly interfere with your ability to work and have a family. Treatment can reduce the severity of the illness, and although some symptoms may continue after treatment, you can go on to have an active social life, raise a family, and work.
Consider the following when making your decision:
- If your symptoms are mild, you can try counseling called exposure and response prevention, a type of cognitive-behavioral therapy, before taking medicines. You may be able to control your OCD without medicines if this method works for you.
- If your symptoms are severe, medicines (antidepressants) will usually be prescribed first. You may want to start counseling at the same time or soon after you begin medicines.
- Antidepressants must be taken as prescribed. If you don't take them regularly, or if you stop taking them, your OCD thoughts and behaviors will probably return.
- Antidepressants have some side effects, and it may take trying different dosages or a different type to find what works best for you. Many side effects go away a few weeks after treatment starts.
- You will want to weigh which is more bothersome for you—the side effects of the medicines or your symptoms and anxiety from OCD.
Medical Information
What is obsessive-compulsive disorder (OCD)?
Obsessive-compulsive disorder (OCD) is a potentially disabling anxiety disorder. A person who has OCD has intrusive and unwanted thoughts and repeatedly performs tasks to get rid of the thoughts. For example, if you have OCD, you may fear that everything you touch is contaminated with germs, and in order to ease that fear, you repeatedly wash your hands.
The effects of OCD range from mild to severe. OCD can disrupt your social life and relationships as well as your ability to work or go to school.
What can I expect if I take medicines?
Medicines can help balance the chemicals in your brain (neurotransmitters) and reduce the intensity of your symptoms. Antidepressant medicines called selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (for example, Prozac), are most commonly used. Your doctor may increase the dosage of your medicine or change to another SSRI if the first medicine prescribed doesn't help. You may start to feel better within 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor.
Your medicine may cause side effects, but they typically go away after your body adjusts to the drug. If not, a different medicine or dosage may work better. Common side effects include:
- Nausea.
- Appetite changes or weight loss.
- Headache.
- Trouble sleeping and tiredness.
- Nervousness.
- Loss of sexual desire or ability and delayed orgasm.
- Dizziness or shakiness (tremor).
What can I expect if I do not take medicines?
If you have mild symptoms, you may be able to control OCD with a type of counseling called exposure and response prevention, a form of cognitive-behavioral therapy.
- Exposure and response prevention provides gradually increasing contact with the feared obsession so that anxiety is reduced. For example, if you were obsessed about germ contamination, you would repeatedly touch an object you believe is contaminated and not wash your hands afterward. You would repeat that behavior until your anxiety was reduced.
- Cognitive therapy may also be used to help overcome the faulty beliefs (such as fear of contamination) that lead to OCD behaviors.
Your Information
Your choices are:
- Take medicines and seek professional counseling to help reduce or control your OCD.
- Do not take medicines. Instead, seek professional counseling to help reduce or control your OCD behaviors.
The decision about whether to take medicines to treat OCD takes into account your personal feelings and the medical facts.
Deciding about medicines for OCD Reasons to take medicines to treat OCD: Reasons not to take medicines to treat OCD:
- You have severe symptoms that interfere with your ability to work and have relationships.
- Counseling has not helped control your thoughts and behaviors to a level that you can live with them.
- You would be willing to take medicines long-term or for the rest of your life if necessary.
- You are willing to try medicine even though you may have side effects.
- Your symptoms are worse than any potential side effects of the medicine.
Are there other reasons you might want to take medicines to treat OCD?
- Your symptoms are mild, and you want to try counseling first.
- You feel the side effects of the medicines would be worse than your symptoms.
- You do not want to take medicines as prescribed for a long period of time.
Are there other reasons you might not want to take medicines to treat OCD?
These personal stories may help you make your decision.
Wise Health Decision
Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about taking medicines to treat OCD. Discuss the worksheet with your doctor.
Circle the answer that best applies to you.
I have mild symptoms that I think I can live with and I want to try counseling instead of medicines.
(If you answer "Yes" to this question, you do not have to answer the following questions.)
Yes No Unsure I do not want to take medicines long-term.
Yes No Unsure I have severe symptoms that interfere with my ability to work and have relationships.
Yes No Unsure I can accept temporary side effects of medicines.
Yes No Unsure I'm willing to take medicines long-term or as long as necessary.
Yes No Unsure Use the following space to list any other important concerns you have about this decision.
What is your overall impression?
Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to use or not use medicines to treat OCD.
Check the box below that represents your overall impression about your decision.
Leaning toward taking medicines
Leaning toward NOT taking medicines
FDA Advisories. The US Food and Drug Administration (FDA) has issued:
- An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.
- A warning about the antidepressants Paxil and Paxil CR and birth defects. Taking these medicines in the first 12 weeks of pregnancy may increase your chance of having a baby with a birth defect.
Return to the topic Obsessive-Compulsive Disorder (OCD).
| Author: | Sabra L. Katz-Wise | Last Updated: July 27, 2006 |
| Medical Review: | Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Lisa S. Weinstock, MD - Psychiatry | |
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