Answer to Medication didn’t work for my OCD

OCD is both a learned and biological disorder. Given this, medications play an important role, but you need to remember that medication affects biology and not the learned parts of OCD. Because of this, medication alone usually results in a 30-50% reduction in symptoms and sometimes the learned parts of the problem are so powerful, that they overshadow the effects of medication. The best plan of attack with OCD is medication and a form of cognitive behavior therapy known as exposure and response prevention. This treatment has been around since 1979 and both the American Psychological Association and the American Psychiatric Assocation recognize this as a core part of OCD treatment. Unfortunately, it is harder to change mental health professionals than it is to help sufferers of OCD, so that there are many mental health practitioners who ignore these recommendations. 

With this in mind, it still may be that besides exposure and response prevention, you needed a higher dose and needed to give medication more time.  As to what is the best one or the ones with least side effects — there are 6 SSRI’s that on the average are all good and tend to not have side effects.  However, individually, there is much variation, so I wouldn’t be able to predict which might have the least side effects or which would work best for you.


    • As I noted earlier, on the average they are equal and tend not to have side effects. However, individually it is more unpredictable. Statistically, zoloft and celexa tend to have fewer side effects, but this doesn’t mean that would be your experience. Similarly, Paxil tends to have more side effects, but you could have none. As you gather, there is a bit of guessing in choosing which medication to try first. But starting with one is better than not trying. And remember, exposure and response prevention is a critical part of treatment, since drugs don’t change learning.

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