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Obsessive-compulsive Disorder

Obsessive-compulsive disorder (OCD) is a mental health condition in which a person experiences persistent, unwanted thoughts (obsessions) and feels driven to carry out repeated actions (compulsions) to relieve the distress those thoughts cause. The cycle is exhausting and self-reinforcing: the compulsion brings only temporary relief, and the obsession returns stronger. OCD is equally common worldwide, affecting roughly 1-3% of populations.

Medicines used to treat Obsessive-compulsive Disorder

Paroxetine

Paroxetine

10 · 20 · 30 · 40mg

Paroxetine 10 to 40 mg tablets, an SSRI antidepressant for depression, anxiety, panic and OCD, the ingredient in Aropax.

FromUS$0.65/ tabletView

Sertraline

Sertraline

25 · 50 · 100mg

Sertraline 25, 50 and 100 mg tablets, an SSRI antidepressant for depression, panic disorder and OCD, the ingredient in Zoloft.

FromUS$0.40/ tabletView

Clomipramine

Clomipramine

10 · 25 · 50mg

Clomipramine 10, 25 and 50 mg tablets, a tricyclic antidepressant for obsessive-compulsive disorder and phobias, the ingredient in Anafranil.

FromUS$0.56/ tabletView

Fluoxetine

Fluoxetine

10 · 20 · 60mg

Fluoxetine 10, 20 and 60 mg, an SSRI antidepressant for depression, OCD and bulimia, the ingredient in Prozac.

FromUS$0.39/ capsuleView

Key points

  • Intrusive, unwanted thoughts drive repetitive actions meant to ease the distress they cause, though the relief never lasts and the thoughts return stronger.
  • Typical obsessions centre on contamination, causing accidental harm, or a need for symmetry, met with rituals like repeated hand-washing or lock-checking.
  • SSRIs such as fluoxetine or sertraline are first-line, with clomipramine an option when they are not enough, alongside cognitive behavioural therapy.

What obsessions and compulsions actually look like

Obsessions are not ordinary worries. They intrude repeatedly and feel alien or shameful, common themes include fears of contamination, harming others unintentionally, symmetry and order, or unwanted sexual or religious thoughts. Compulsions are behaviours or mental acts carried out to neutralise the obsession: hand-washing, checking locks, arranging objects, silently counting, or seeking reassurance. Most people with OCD recognise the behaviour is irrational but feel unable to stop without help.

How OCD is treated

The main evidence-based approach combines cognitive behavioural therapy (CBT), specifically exposure and response prevention (ERP), with medication. Several medicines from the antidepressants group are established first-line treatments for OCD. Serotonin reuptake inhibitors are the drug class of choice; options include fluoxetine, sertraline, fluvoxamine, and paroxetine. When those do not produce enough improvement, clomipramine, a tricyclic antidepressant with strong serotonin activity, is often tried. Effective doses for OCD are typically higher than those used for depression, and a full response can take 10-12 weeks.

When to seek help

OCD rarely resolves without treatment, and symptoms tend to worsen under stress. If intrusive thoughts or rituals are taking up more than an hour a day or are affecting work, relationships, or sleep, a mental health assessment is worthwhile. If you are in crisis, the International Association for Suicide Prevention maintains a directory of crisis centres at https://www.iasp.info/resources/Crisis_Centres/.

Further reading

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