Medication and obsessive compulsive disorder (OCD)

Strong evidence – there is lots of high-quality evidence that some young people find this treatment option helpful.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are a group of medications used to treat depression, which can also be helpful for OCD. This medication could be offered to you if:

  • after 12 weeks of CBT-ERP your symptoms have not improved
  • from the start you do not want CBT-ERP
  • from the start your symptoms are very severe, when you might be prescribed medication combined with CBT-ERP

Fluvoxamine or Sertraline will usually be the first SSRI medications recommended to you by your professional.

Your professional might also recommend other SSRIs if they would suit you better, for example if you take other medications. If you also have depression, your professional might suggest Fluoxetine instead.

Medication combined with CBT-ERP

Unless you do not want CBT-ERP, you should continue with CBT-ERP while taking medication as this is usually more helpful. However this does mean it can be difficult to know which part of your treatment was the most helpful, which your professional might talk to you about when you come to stopping the medication.

Sometimes if the medication reduces your anxiety a lot early on in your treatment, it can make it harder to do the CBT-ERP as this relies on your experiencing anxiety and learning to manage it.

Review of medication

SSRIs take several weeks to work to improve your OCD symptoms, and the dose usually needs to be increased gradually to reach an effective level.

If after 3 months at an appropriate dose the first-choice medication has not worked for you, then your professional might suggest a multidisciplinary review.

After this review, your professional might offer you different SSRI medication. Alternatively, you might switch to an older medication called clomipramine. Clomipramine has been found to be more helpful than the other SSRIs but also has more side-effects.

There is less research evidence on treatment when SSRIs and clomipramine haven't worked in combination with CBT-ERP. If this is the case for you then your professional might seek advice from a specialist OCD service, where they are likely to see more people who have not responded to usual treatments. They might suggest combining different SSRI medications, or adding a low dose of an antipsychotic medication such as risperidone or aripiprazole.


Although medication for OCD can be effective, it is common to relapse once you stop taking the medication. This means your OCD symptoms could return. It is important to know that medication is more effective if combined with CBT-ERP.

Treatments outlined on these webpages may not be available in every local area. It’s important that you discuss with your GP or mental health professional the treatment options available to you. You can also search for services near you on our Youth Wellbeing Directory and find out more about referral processes here.

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