The main medications for Obsessive-Compulsive Disorder

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

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 lifetime.

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

• Related article: "Types of psychotropic drugs: uses and side effects"

What is Obsessive-Compulsive Disorder?

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

Although the severity of the disorder is highly variable, depending on the type of behavior that the patient manifests, as a general rule it usually involves a high degree of interference in his life. Despite this, few people seek professional help, calculating that Only 35% to 40% of OCD sufferers attend therapy of their own free will.

Given that OCD has its roots in aspects of the personality of the individual who suffers from it, it is not possible to speak of a treatment that will "cure" it completely. That is why, in most cases, therapy is aimed at helping the patient to acquire control over his obsessions and compulsions, rather than eliminating them completely. For this reason, patients with the disorder must go to therapy for life, in most cases.

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

Medications for OCD

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

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 contribute to having a euthymic state of mind, that is, not pathological. Since OCD is an anxiety disorder, and antidepressants are also used for these types of disorders, it is not surprising that they have use for this particular disorder.

Antidepressants are drugs that help regulate, especially serotonin levels, a neurotransmitter, in the synaptic cleft, preventing it from being recaptured and taken into the neuron.

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

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

Other antidepressants used for OCD are Serotonin and Noradrenaline Reuptake Inhibitors., drugs that, in addition to acting on serotonin collection mechanisms, intervene in other neurotransmitters, in this case, norepinephrine. Among the drugs within this group we find the venlafaxine and the mirtazapine, and they are used when, once the SSRIs are prescribed, they have not been effective for the patient or, in addition to OCD, they also present depression.

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

Between the precautions of antidepressants, whether they are SSRIs or SNRIs, we found that they should not be prescribed in pregnant or breastfeeding women, the elderly, or those who suffer from heart problems.

It goes without saying that, although most antidepressants are safe, there is a risk that they promote the appearance of suicidal thoughts and suicide attempts. It has been seen that children and adolescents who have been prescribed these drugs may have an increase in ideation suicidal, especially during the first weeks of treatment or when the dose of the medicine has been modified. However, these adverse effects are temporary, with significant long-term improvement.

Although antidepressants are not considered addictive, it is possible that there may be some physical dependence on them. This dependence is different from what is understood by addiction, but it does require that the interruption of the treatment is done on a regular basis, progressively reducing the doses instead of stopping the treatment of blow. In doing so, the person may manifest withdrawal symptoms, which is known as discontinuation syndrome.

• You may be interested: "Types of antidepressants: characteristics and effects"

Antipsychotics

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

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

Other drugs

Currently, research is being done on the use of several alternative drugs, especially those that intervene on the glutamatergic pathways in the brain. 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. Drug addiction magazine, 12. 12 - 21.
• American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
• World Health Organization (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. Behavior Research and Therapy 41 (6): pp. 681 - 700.