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Obsessive-compulsive disorder (OCD) is a condition characterized by obsessions and compulsions.

Obsessions are persistent and intrusive thoughts, urges, or images. They’re unwanted and often lead to anxiety, fear, or distress. Attempts to ignore them are difficult and often unsuccessful. A person with OCD tries to alleviate their obsessions by engaging in compulsive behaviors. 

Common obsessions include:

• Fear of contamination or germs 
• Need for order, symmetry, or balance
• Unwanted thoughts of an aggressive, sexual, or religious nature 
• Fear of not being able to control your behavior and harming yourself or someone else

Compulsions are repetitive behaviors or mental acts performed in response to obsessions. The goal is to reduce anxiety, fear, or distress. The ritualistic behaviors can be time-consuming and affect your daily functioning. 

Common compulsions include: 

• Excessive hand washing
• Checking things repeatedly
• Counting or ordering items
• Repeating words, phrases, or prayers

To diagnose OCD, a licensed mental health professional conducts a comprehensive assessment. This may include clinical interviews and standardized measures to help your provider better understand your experience. 

During a clinical interview, your provider asks about your symptoms, the severity, the nature of your obsessions and compulsive behaviors, how they’ve affected your day-to-day functioning, and your medical history to help them rule out other conditions. 

A comprehensive assessment may include measures like the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), which can be administered by the provider or as a self-report measure, to assess the severity of intrusive thoughts and ritualistic behaviors. It can also be used to monitor your symptoms over time. 

It can take some time for a provider to make an accurate diagnosis. But a proper diagnosis is needed to ensure you get the right care. Once diagnosed, your provider will recommend an OCD treatment plan with options based on your individual needs and the severity of your OCD symptoms.

A class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacological treatment for OCD. SSRIs work by increasing levels of serotonin, a brain chemical that plays an essential role in regulating mood, behavior, memory, appetite, sleep, and stress. 

SSRIs are effective in helping reduce obsessive thoughts and compulsive behaviors. Some common antidepressants prescribed for OCD when a provider feels it medically necessary include:

• Anafranil (clomipramine)
• Luvox (fluvoxamine) 
• Paxil (paroxetine)
• Prozac (fluoxetine)
• Lexapro (escitalopram) 
• Wellbutrin (bupropion)

If your OCD symptoms are severe, disrupting your daily life, or if you have another mental health condition, like anxiety or depression, that exacerbates your OCD, your provider may recommend medication in addition to therapy to help you find relief. 

Anafranil, Luvox, Paxil, and Prozac, are all FDA approved to treat OCD. Lexapro is FDA-approved to treat major depressive disorder (MDD) and generalized anxiety disorder (GAD). Wellbutrin is FDA-approved to treat MDD and seasonal affective disorder (SAD). Some providers may use them for OCD off-label (for a use they’re not FDA-approved for). 

All medications, including those listed here can have side effects, some serious. SSRIs have a boxed warning for increasing the risk of suicidal thoughts and behaviors in children and adolescents. Before you take any medications, talk to your provider so you understand all possible side effects, drug interactions, and contraindications.