Top medications for Obsessive-Compulsive Disorder

These are the most commonly used psychotropic drugs to treat people with OCD.

OCD is seen, in many occasions, more as a peculiarity than as what it really is, a psychological disorder, and as any disorder it implies interference in the life of the person who suffers from it.

That is why people with this disorder should receive treatment, either in the form of psychotherapy or with psychotropic drugs, so that they can have a significant improvement in their quality of life.

In this article we will look at the main medications for OCDTheir adverse effects, their precautions and the mechanisms that explain why they are beneficial for people diagnosed with the disorder.

What is Obsessive-Compulsive Disorder?

Obsessive-Compulsive Disorder (OCD) is the fourth most common disorder, behind only phobias, addictions and depression. The first symptoms of this psychological problem manifest themselves in childhood, worsening as the individual grows older. Among the most notable behaviors of patients with this disorder we find rituals, perfectionism and manias, behaviors which appear in times of particular stress..

Although the severity of the disorder is very variable, depending on the type of behaviors that the patient manifests, as a general rule it usually involves a high degree of interference in his or her life. Despite this, few people seek professional help, and it is estimated that only between 35% and 40% of patients seek professional help. only 35% to 40% of OCD sufferers seek therapy of their own volition..

Since OCD is deeply rooted in personality aspects of the individual who suffers from it, it is not possible to speak of a treatment that can 'cure' it completely. That is why, in most cases, therapy is aimed at helping the patient gain control over his or her obsessions and compulsions, rather than eliminating them completely. For this reason, patients with the disorder will need to attend therapy for life, in most cases.

The two main avenues of treatment for OCD, both of which have scientific evidence behind them, are psychotherapy, especially cognitive-behavioral therapy (CBT), and medication.. Alternative treatments such as homeopathy, herbal medicine, meditation, exercise or Mindfulness, to date, lack adequate scientific evidence to demonstrate a significant improvement in the patient's life, although this does not mean that the latter treatments cannot be potentially therapeutic.

Medications for OCD

There are several medications for OCD, although their use varies depending on the characteristics of the person, the severity of their obsessions and compulsions, how effective previous treatments have been and the occurrence of adverse effects.

Antidepressants

Usually, the first treatment option is the use of antidepressants. The name of this group of drugs may lead one to think, erroneously, that they are only prescribed for depression, but the truth is that they contribute to a euthymic, i.e. non-pathological, state of mind.. Since OCD is an anxiety disorder, and antidepressants are also used for anxiety disorders, it is not surprising that they are used for this particular disorder.

Antidepressants are drugs that help to regulate, above all, the levels of serotonin, a neurotransmitter, in the brain.a neurotransmitter, in the synaptic cleft, preventing it from being reuptaken and taken into the interior of the neuron.

Among the most specialized in this function are the Selective Serotonin Reuptake Inhibitors, whose action is exclusively focused on the reuptake of this neurotransmitter. Among these drugs we find fluoxetine (Prozac), fluvoxamine, paroxetine (Paxil, Pexeva), escitalopram (Lexapro), citalopram (Celexa) and sertraline (Zoloft).

In the case of children who have been diagnosed with OCDThe two Antidepressant drugs usually prescribed are sertraline, for those over 6 years old, and fluvoxamine, for those over 8 years old.

Other antidepressants used for OCD are Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs).drugs that, in addition to acting on the serotonin reuptake mechanisms, intervene on other neurotransmitters, in this case, noradrenaline. Among the drugs in this group we find venlafaxine and mirtazapine, and they are used when, once SSRIs have been prescribed, they have not been effective for the patient or, in addition to OCD, he/she also presents depression.

Also of note is a tricyclic antidepressant used for OCD: clomipramine (Anafranil).

Visit precautions for antidepressants, whether SSRIs or SNRIsIn addition, we found that they should not be prescribed to pregnant or breastfeeding women, elderly people or those who suffer from heart problems.

It should be noted that, although most antidepressants are safe, there is a risk that they may encourage suicidal thinking and self-inflicted suicidal attempts.. It has been seen that children and adolescents who have been prescribed these drugs may have an increase in suicidal ideation, especially during the first weeks of treatment or when the dosage of the medication has been modified. However, these adverse effects are temporary, with significant long-term improvement.

Although antidepressants are not considered addictive, some physical dependence on them is possible.. This dependence is different from what is understood as addiction, but it does require that the interruption of the treatment be done in a patterned manner, progressively reducing the doses instead of stopping the treatment all at once. If this is done in this way, it is possible that the person may manifest withdrawal symptoms, which is known as discontinuation syndrome.

Antipsychotics

Another group of drugs used to medically treat OCD are antipsychotics. These drugs are not used separately, but in combination with SSRIs, since they enhance their therapeutic effects.These drugs are not used separately, but in combination with SSRIs, since they improve their therapeutic effects, significantly reducing the symptoms of the disorder.

Among the most commonly used are risperidone (Risperdal), haloperidol (Haldol), olanzapine (Zyprexa), quetiapine (Seroquel) and aripiprazole (Abilify).

Other drugs

Research is currently underway on the use of several alternative drugs, especially those that intervene on the cerebral glutamatergic pathways. The most studied are memantine (Namenda), topiramate (Topamax) and riluzole (Rilutek)..

Bibliographic references:

• Jenike MA. "Clinical Practice: Obsessive-Compulsive Disorder," New England Journal of Medicine (Jan. 15, 2004): Vol. 350, No. 3, pp. 259 - 65.
• Koran LM, et al. "Practice Guideline for the Treatment of Patients with Obsessive-Compulsive Disorder," American Journal of Psychiatry (July 2007): Vol. 164, No. 7, Suppl., pp. 5 - 53.
• Jefferson, J. W. and Greist, J. H. (1997). Pharmacological treatment in obsessive-compulsive disorder. Journal of substance abuse, 12. 12 - 21.
• American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
• Organización Mundial de la Salud (1992). International Classification of Diseases and Health Related Problems, Tenth Revision (ICD-10). Geneva.
• Colesa, M.E.; Frostb, R.O.; Heimberga, R.G.; Rhéaumec J. (2003). “Not just right experiences”: perfectionism, obsessive–compulsive features and general psychopathology. Behaviour Research and Therapy 41 (6): pp. 681 - 700.