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Seeking Advice on Medication for OCD Symptoms
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Mental & Emotional Health
Question #28729
90 days ago
188

Seeking Advice on Medication for OCD Symptoms

Client_3fc49a

Dear Doctor, I have severe OCD, especially related to compulsions. Obsessions: I have very disturbing sexual obsessions—sexual thoughts and images, violent thoughts, concerns about symmetry and cleanliness. For example, sexual thoughts come to my mind and do not go away quickly. I also have sexual obsessions regarding people I interact with, especially schoolmates. Overall, sexual obsessions are the strongest for me. I have undergone psychotherapy, which has been very effective. After three months, my OCD symptoms have decreased significantly. However, sometimes, for example while studying or under academic pressure, the obsessions become stronger. When my academic workload is low, my obsessions are weaker. They also worsen when I am under social pressure. I also read a book that helped me a lot: “Unlocking the Obsessive Brain” from UCLA in New York. Compulsions: I have the compulsion to pull or pick (skin/hair), but my compulsions are much less severe compared to my obsessions. I am 17 years old. Based on my research from books and other sources, SSRIs seem suitable for me, especially Sertraline and Fluoxetine, but I am worried about their side effects and whether they could harm me. If possible, could you advise which medication would be most suitable for me? I have had OCD for approximately three years, as far as I can remember, but I cannot be sure about my childhood. In the last six months, my symptoms have become strong enough to affect my daily life. In conclusion, after three months of psychotherapy, about half of my OCD symptoms have improved, but sometimes they become strong again, and I feel I need medication.

How would you rate the severity of your OCD symptoms currently?:

- Severe, significantly affecting daily life

Have you experienced any side effects from medications in the past?:

- No, never taken medication

How often do you feel overwhelmed by your obsessions?:

- Frequently, daily
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Doctors' responses

You are a experiencing daily worsening of obsessive thoughts consistent with Obsessive compulsive disorder, and it is very positive that psychotherapy has already helped you significantly. However, since symptoms still persist and affect your daily life, adding medication can be beneficial, but this must be done under the supervision of a psychiatrist, especially at your age. The most commonly used and effective medications are Selective serotonin reuptake inhibitors such as fluoxetine, sertraline, or fluvoxamine, which help reduce obsessive thoughts and anxiety over time. These medicines require proper dosing, monitoring, and follow-up to avoid side effects and ensure safety. You should not start any medication on your own. In summary, your condition is treatable, therapy is already helping, and with proper psychiatric guidance, combining therapy with medication can further improve your symptoms and quality of life.

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Hello

You’ve described your situation very clearly, and it’s encouraging that psychotherapy has already reduced your symptoms significantly. For a 17-year-old with persistent symptoms that still interfere with daily life, adding medication to therapy is a standard and evidence-based next step for managing Obsessive-Compulsive Disorder.

About medications: Both Sertraline and Fluoxetine are commonly used and considered safe for adolescents when prescribed and monitored by a qualified clinician. They do not harm the brain or personality, and many young people take them temporarily while therapy continues.

Side effects: Most are mild and temporary (nausea, headache, sleep changes, slight anxiety at the start). Serious side effects are uncommon, and doctors begin with a low dose and adjust gradually to minimize risk. These medications are not addictive.

Which is “most suitable”? There is no single best choice for everyone, but in adolescents:

• Sertraline is often chosen when anxiety and intrusive thoughts are prominent. • Fluoxetine is often chosen because it has a long safety track record and once-daily dosing. Both are reasonable options; the final decision depends on your medical history, weight, sleep pattern, and response to therapy.

Important practical points: • Continue psychotherapy (especially CBT with exposure and response prevention), because medication works best together with therapy. • It may take 4–8 weeks to see clear improvement after starting medication. • Symptoms often flare during academic or social stress—this pattern is very typical in OCD and does not mean treatment is failing.

When medication is strongly considered: • Symptoms remain severe despite therapy • Daily functioning (study, sleep, relationships) is affected • Distress is high or relapses occur with stress

Your situation—partial improvement but ongoing significant symptoms—fits this category, so discussing medication with a psychiatrist is very reasonable.

Take care Regards

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When considering medications like SSRIs for OCD, such as Sertraline or Fluoxetine, it’s crucial to balance the potential benefits against possible side effects. Both Sertraline and Fluoxetine are commonly prescribed for OCD and have been shown to effectively reduce symptoms of both obsessions and compulsions. However, individual responses can vary, and this should be carefully monitored by a healthcare provider. Generally, SSRIs can take several weeks before you might notice significant improvements. Common side effects might include nausea, headaches, sleep disturbances, or increased anxiety initially, but these often diminish over time. It’s also important to consider that SSRIs are typically well-tolerated in the majority of patients, especially with proper dosage adjustments led by a doctor. Given your age, it’s also worth discussing because, sometimes, young individuals might be more sensitive to certain side effects, including mood changes. Therefore, having a healthcare provider guide this process is essential. You mentioned psychotherapy was effective, which is great, and combining it with medication sometimes yields even better results. There may also be alternative medications if one SSRI doesn’t suit you, or doses that can be adjusted. Remember, lifestyle factors, like stress management and routine, can also interact significantly with OCD symptoms and should be managed alongside medication. It’s important to keep an ongoing dialogue with your doctor about your symptoms and concerns to tailor the most effective treatment plan for you. Please ensure you have an open conversation with a healthcare professional before starting any medication, they can help guide this process and ensure it’s done safely.

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Hello dear See ocd is not a disease but is a combination of strict regular habits and anxiety. Iam suggesting some precautions for improvement Please follow them for atleast two months Do physical exercise atleast half an hour daily for 5 months Do meditation Take good balanced diet for good health Engage in social media Indulge in hobbies like reading and writing Avoid overthinking Avoid junk food and alcohol/ smoking Set your goals for every day Hopefully improvement will occur In case of no improvement in 2 month consult psychiatrist in person for better clarity Regards

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