Antidepressant and Antipsychotic Drugs Used to Treat OCD

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Obsessive-compulsive disorder is commonly treated with both medication and cognitive-behavioral therapy. Medications that target serotonin pathways in the brain, like antidepressants, are particularly effective in treating people with OCD —and if this doesn't work, adding on an antipsychotic medication may be useful.

Let's take a look at the various medications used to treat OCD, including antidepressants and antipsychotics that have found to be effective in scientific studies.

FDA Approved OCD Medications

There are a number of medications that have been approved by the Food and Drug Administration (FDA) for the treatment of OCD. Most of these drugs belong to a class of antidepressants called the selective serotonin reuptake inhibitors. However, one of these drugs, Anafranil, belongs to a class of drugs called the tricyclic antidepressants.

OCD medications approved by the FDA specifically for the treatment of OCD include:

  • Anafranil (clomipramine)
  • Prozac (fluoxetine)
  • Luvox (fluvoxamine)
  • Paxil (paroxetine hydrochloride)
  • Zoloft (sertraline)

Off-Label Medications

Although not formally approved by the FDA for the treatment of OCD, other types of SSRIs, as well as serotonin and norepinephrine reuptake inhibitors (SNRIs), are being prescribed by physicians "off-label" as OCD medications. Some examples of off-label OCD medications include:

  • Celexa (citalopram)
  • Lexapro (escitalopram)
  • Effexor (venlafaxine)

Antipsychotic Medications

Antipsychotic medications are not used to treat OCD alone. Rather, they are often used to augment or improve the effectiveness of SSRIs and clomipramine in reducing OCD symptoms.

Usually, augmentation therapy is implemented when clomipramine or SSRIs fail to improve OCD symptoms after at least three months.

Antipsychotics that have shown mixed results when used to augment SSRI therapy for OCD include:

  • Zyprexa (olanzapine)
  • Seroquel (quetiapine)

Aripiprazole (Abilify) has also shown promise as a therapy for OCD.

Medications on the Horizon

Medications that target glutamate pathways in the brain are among the novel drugs that may help reduce symptoms of OCD, especially when added to an antidepressant. These include:

  • Memantine (Namenda)
  • Topiramate (Topamax)
  • Riluzole (Rilutek)

A Word From VeryWell

As with any medical treatment, the decision to start a new medication or add a medication to your treatment strategy is a choice that should be made in strong collaboration with your family doctor or psychiatrist.

OCD Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

Mind Doc Guide

Be sure to speak as honestly as you can about your symptoms in order for your doctor to develop a plan that works for you. In addition, simply because a medication is prescribed doesn't mean that the communication between you and your mental health professional is over.

It's important that you continue to make note of and provide feedback on any side effects, mood changes, or differences you experience from any medication.

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Article Sources
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Additional Reading
  • Bloch, M.H., Landeros-Weisenberger, A., Kelmendi, B., Coric, V., Bracken, M.B., & Leckman, J.F. "A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder." Molecular Psychiatry 2006 11: 622-632.

  • Pizarro et al. An updated review of antidepressants with marked serotonergic effects in obsessive-compulsive disorder. Expert Opin Pharmacother. 2014 Jul;15(10):1391-401.

  • Schruers K, Koning K, Luermans J, Haack MJ, Griez E. Obsessive-compulsive disorder: a critical review of therapeutic perspectives. Acta Psychiatr Scand. 2005;111(4):261-71. doi:10.1111/j.1600-0447.2004.00502.x