3D illustration of "SSRI" title on pill bottle, isolated on white.

There are a number of treatments options for children and adults with Obsessive-Compulsive Disorder (OCD) that evidence shows can be helpful, including psychological therapies and medication.

The primary treatment approach for most people volition be to start with psychological treatment in the form of Cognitive Behavioural Therapy (CBT).  Still, for some people where therapy as not proved successful initially, the NICE guidelines recommend boosted therapy (CBT with ERP), or a pick of medication in the class of Selective Serotonin Reuptake Inhibitors (SSRI).

Although medication is not recommended as an initial treatment method for most people with OCD, in the past many people were offered medication whilst on long waiting lists for psychological therapy.  If this happens, it should be your pick whether to try medication or not.

Your healthcare professional should discuss all your treatment options with you so y'all tin can make up one's mind if you lot want to have a particular treatment or non, and which treatment you might adopt. Your ain preference is important and after a full discussion your healthcare professional person should back up your choice where possible.

Whilst some people may be anxious about taking medication, the medication could be helpful in dealing with the OCD and/or with the reduction of anxiety and improvement on low feelings plenty to make information technology easier to start, and eventually succeed, in therapy.

The types of Medications

The medication used for treating OCD usually accept the form of antidepressants which act in the serotonin system, and are called Selective Serotonin Re-uptake Inhibitor, or SSRIs for short.

Image of two spikes, one sharp the other rounded

SOME USERS HAVE DESCRIBED IT TO US THAT THE ANXIETY EXPERIENCED BY OCD CAN Feel Similar A SHARP SPIKE, Only AFTER TAKING MEDICATION, THAT Abrupt Fasten BECOMES MORE OF A ROUNDED SPIKE.

Nosotros do not know exactly why SSRIs are helpful for some people with OCD, it's thought they might have an effect past altering the remainder of chemicals in your brain, merely what we do know is that they sometimes reduce the severity of obsessive-compulsive symptoms, past taking the 'edge' off some of the anxiety experienced.  Some users have described it to us that the feet experienced by OCD tin can feel like a sharp spike, simply after taking medication, that sharp spike becomes more than of a rounded fasten.

Medication types used to treat OCD:

Drugs often accept several names. When a drug is first discovered it's given an canonicalgeneric name merely since medicines are often made by different companies, they also have ane or more thanmake (trading) names, making information technology very confusing.  The brand name is ofttimes called to be memorable for advertising, or to be easier to say or spell than the generic name which can frequently be cumbersome. For example, the generic proper name for Prozac is Fluoxetine.  Whilst the brand name is usually written nearly conspicuously on any packaging, you will e'er see the generic name written somewhere on the packet or leaflet, although often in pocket-sized print.

Here in the Uk at that place are strict quality controls before a product licence is granted for brand versions of medicines. This means that in theory a generic or brand proper noun version of the aforementioned medicine will have the same activeness and be of the aforementioned quality. Although some users have told us that they take noticed a divergence, for example in 2015 when Anafranil was discontinued, a handful of users struggled taking the generic version, Clomipramine.

So with each drug recommended for the treatment of OCD we will list both the generic and brand name, if you lot are confused over medication names, please practise discuss with your prescribing medico.

Selective Serotonin Reuptake Inhibitors (SSRI)
SSRI medications are unremarkably tried first (earlier non-selective SRIs) because SSRIs but act on serotonin. The SSRIs usually recommended for the treatment of OCD in the United kingdom of great britain and northern ireland are:

Generic Name / (Brand Names)

  • Citalopram (Celexa, Cipramil)
  • Escitalopram (Cipralex, Lexapro)
  • Fluoxetine (Prozac)
  • Fluvaxamine (Faverin, Luvox)
  • Paroxetine (Paxil, Seroxat)
  • Sertraline (Lustral, Zoloft)

If these medications fail to piece of work, a not-selective SRI may be prescribed. However, because it affects neurotransmitters in the encephalon other than just serotonin, there are more side effects and therefore it is ordinarily not a offset choice medication for treating OCD. The not-selective SRI most commonly used for treating OCD is:

Tricyclic Antidepressant (TCA)

  • Clomipramine (Anafranil)

The NICE guidelines  state:

Clomipramine should be considered in the handling of adults with OCD or BDD later on an adequate trial of at to the lowest degree 1 SSRI has been ineffective or poorly tolerated, or if the patient prefers Clomipramine or has had success in using the medication before.

Typically, the process of determining the well-nigh suited medication for an individual is achieved on a trial-and-error basis. However, in order to allow its maximum effects to be adequately observed, each medication should be taken for a specified time period, ordinarily for at least 12-16 weeks, before seeking out an alternative, but ever discuss with your prescribing doctor earlier making any changes to your dosage or type of medication.

This is not an exhaustive list, and sufferers may oftentimes be prescribed additional medications to enhance or augment the effects of these SSRIs. For case, part of the criteria to access some of the NHS national treatment clinics is augmentation of medication, which could include anti-psychotic medications alongside SSRI. Although the efficacy of anti-psychotics for the treatment of OCD is open to debate with some inquiry suggesting information technology's no more effective than placebo.

Medication for Children
For children, the Nice Guidelines for the treatment of OCD suggested that two of the SSRI'southward listed had a UK marketing authorisation for treating OCD in children. Those were:

  • Fluvoxamine (8 years and older)
  • Sertraline (6 years and older)

Although in exercise other medications may be prescribed to children, information technology's worth pointing out that the Squeamish Guidelines were published in 2005, so knowledge around using SSRIs for children with OCD volition have come on since publication. If a child is prescribed another drug to those listed in a higher place, information technology's worth request the prescribing doctor why  an alternative medication is being prescribed to their child instead of ane of the above 2 medications.

Medication and side effects

All medications have the potential for side effects, but that does not mean every person volition suffer with side furnishings.  We all take unlike bodies and tolerances to medications, so 10 people could be offered the exact same type, brand and dosage of medication and results will vary from the negative (making them experience worse) through a range of side effects to the positive results without whatsoever side effects at all.  And then it is important yous ask a prescribing doctor to discuss the potential side effects with you, Of course the reality is, until y'all start taking any medication you won't know if you volition take whatever side effects at all.  Click here to read more about potential side effects.

Coming off Medications

Although someone on medication may end taking SSRIs whenever they wish, we always recommend that they're reduced gradually nether supervision from their prescribing doctor.

Information technology'south besides worth pointing out that NICE recommend, that if the medication has helped a person, they should continue taking the medication for at least 12 months to ensure their symptoms continue to improve and to prevent relapses.

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