Obsessive Compulsive Disorder (OCD) is a mental illness concerned with recurrence of images or upsetting thoughts and fear about something. The occurrence of these unwanted and distressing thoughts compels the person to perform some ritualistic behaviours or actions to get rid of the obsessions or to stop them from coming in. Gradually, excess of obsessive habits turn disastrous. The continuous anxiety due to obsessions and ritualistic behaviour or action performed as compulsion takes hours of time leaving him/her in a situation where the daily activities are at loss. Obsessive Compulsive Disorder (OCD) can also bring in adjustment and relationship issues and the person is mostly isolated. To cater to the situation and to reduce the distress, one must seek medical attention. Due to the severity of the Obsessive Compulsive Disorder (OCD), the treatment process is mainly a combination of more than one method.
Medications to Treat Obsessive Compulsive Disorder
Due to the severity of the OCD, many a times medications are required to reduce the distress of the obsessional thoughts and images and also to reduce anxiety. The most common form of medication given to treat Obsessive Compulsive Disorder is Selective Serotonin Reuptake Inhibitors (SSRIs) which are usually used as anti-depressants; however, it is a very effective medication in treating Obsessive Compulsive Disorder (OCD) as well. The types on anti-depressants and their dosages that help in treating OCD are as follows:
- Sertraline (Zoloft) – up to 200mg/day
- Fluvoxamine (Luvox) – up to 300mg/day
- Clomipramine (Anafranil) – up to 25mg/day
- Paroxetine (Paxil) – 40-60mg/day
- Citalopram (Celexa) – up to 40mg/day
- Escitalopram (Lexapro) – up to 40mg/day
- Venlafaxine (Effexor) – up to 375mg/day
- Fluoxetine (Prozac) – 40-80mg/day
Clomipramine is the oldest drug that is used most widely and is extensively studied medicine for its use for treating Obsessive Compulsive Disorder (OCD). It has consistently shown positive results. Whereas Fluoxetine and Paroxetine were effective only in controlled studies, others have shown equal effectiveness in open trials.
For children only few of these medications are permitted by the FDA. These are Sertraline for children who are 6 years and older, Fluoxetine and Fluvoxamine for children who are 8 years old and above. Clomipramine has also shown its effectiveness in treating OCD in children; yet, it is only permitted to be prescribed for kids who are 10 years and above. However, it must be kept in mind that there are increased chances of occurrence and severity of side effects with usage of Clomipramine in children.
Psychiatrist might also prescribe some atypical antipsychotic medications which work well for reducing Obsessive Compulsive Disorder (OCD) symptoms. They are:
Even some benzodiazepines help in relieving the symptoms of anxiety in OCD patients. However, in majority of the cases, benzodiazepines are used along with other medications and reliable treatment methods. The most preferred way of treating Obsessive Compulsive Disorder (OCD) is using a combination of Cognitive Behavioral Therapy along with suitable medications.
Do All Anti-Depressants Work Well for Obsessive Compulsive Disorder?
No, not all anti-depressants help in relieving Obsessive Compulsive Disorder (OCD) symptoms. The most popular and commonly used drugs, Amitriptyline (Elavil) and Imipramine (Tofranil) which are good anti-depressants, seldom helps in relieving OCD symptoms.
Common Side Effects of Medications Used to Treat Obsessive Compulsive Disorder
The most common side effects of medications used to treat Obsessive Compulsive Disorder (OCD) are:
- Fall in Blood Pressure when getting up from a seated position
- Dry mouth
- Difficulty in starting of urination
- Stomach upset
- Blurred vision
- Lower libido
- Increased risks of suicidal thoughts and actions. This must be immediately conveyed to the doctor if you are having thoughts of committing suicide or making a plan. Even if the family members note this symptom, it must be immediately conveyed.
SSRIs also pose a small risk for triggering heart problems. Hence, the doctor might ask you to get an electrocardiogram (ECG) done before you start with the medication and also after a few weeks of starting with medication.
Some of the medications to treat Obsessive Compulsive Disorder (OCD) might interact dangerously with food, medications, alcohol or other substances that you are using. Do consult with the doctor about all the medications that you take including all vitamins, minerals and herbal supplements along with any over-the-counter medications.
What If I Develop Severe Side Effects Even After Taking the Smallest Dose of Medications to Treat Obsessive Compulsive Disorder?
In case, you develop adverse effects of medicines do talk to the doctor for change of medications. The doctor might start the doses from even 1-2 mg/day and then slowly increase the dosage to reduce side effects. If required, they might also ask you to take liquid form of the medicine to dilute the dosage. This in many cases help in reducing the side effects and then slowly increase the dosage to the required amount. Do not alter the dosage or way of intake without asking your doctor.
Do I Take The Medicines Only When Feeling Anxious?
No. These medicines need to be taken everyday unlike any anxiety medicines to keep the Serotonin levels in the blood under check. The best way is not to skip any medication until the doctor says. At times, your doctor might prescribe you to skip a certain number of dosages to help manage side effects viz., sexual problems or low libido.
How Long Do I Need to Take the Medications for Obsessive Compulsive Disorder?
Typically, the medications take around some weeks to 3 months before a noticeable change in symptoms is observed. It is very important that one continues the medication till then without fail. An important thing with OCD medication is that there is no particular medicine for treating it. The doctor will choose a best suited medication depending on the condition. However, it is possible that even a change of medication is required after using it for the first 3 months due to excess of side effects or no reduction in symptoms. While treating OCD, it isn't very uncommon that the doctor would change the medication 2-3 times before the best suited medicine is found that provides highest benefits and lowest possible side effects.
The duration of the medications to be used usually varies. Ideally, once the best suited best medicine with lowest side effects and highest benefits is found, it should be continued for the next 6 months to one year. However, this duration would vary depending on the severity and recovery from the condition. In some cases, it would continue for years even after the symptoms get better.
The duration of medication to treat Obsessive Compulsive Disorder (OCD) also depends on the chances of relapse of symptoms once the medications are stopped. The relapse might take place after days, weeks or months after the medicine is stopped. However, the best part is when the medications are started again, a quick recovery is seen. The chances of relapse of OCD are lesser if a combination of cognitive behavioural therapy and medication is taken and when the dosage is reduced slowly over a prolonged period of time and then stopped.
Alternative Treatment for Obsessive Compulsive Disorder
Besides taking assistance from the severe and hard treatments, patients can opt for a lighter treatment along with medications and psychotherapy for sure-shot improvements. These are:
- Inositol Treatment for OCD: As an efficient form of Vitamin B, it is considered highly important in treating OCD. Being a part of the biochemical process affecting Serotonin Receptors, Inositol is the perfect way of controlling the aggravated situation of Obsessive Compulsive Disorder. This treatment should be taken under a trained medical supervisor for a period of about 6 weeks or less; depending on the condition of the patient.
- Relaxation Techniques for OCD: Patients can also practice relaxation techniques by doing Yoga, meditation, deep breathing and various other stress relief techniques. It is mandatory to practice such techniques for a period of about at least 30 minutes every day. As the mind gets habitual of getting relaxed, the anxiety symptoms would reduce. There is also an increased need to have enough sound sleep that might provide a better control over mind.
OCD is not a very serious problem if it is identified at an early stage. However, this can turn out to be fatal on not getting treatment at the right time. It is important to abide by the doctor's prescription and not to experiment with the drugs such as increase or reducing the dosage by oneself. Your trust on the doctor and a positive outlook for the recovery and help you come out of the situation sooner.