Lexapro for OCD: Everything You Need to Know

How Does Lexapro for OCD Work?

Lexapro, while not FDA-approved specifically for the treatment of OCD, is sometimes prescribed off-label for this condition. “Off-label” means that the medication is being used for a condition not approved by the FDA. A healthcare provider may prescribe a medication for off-label use if they believe it may benefit someone.

Lexapro is often used for OCD due to its function as a selective serotonin reuptake inhibitor, which can help increase and regulate serotonin levels in the brain. Since serotonin plays a role in mood and anxiety regulation, increasing levels of serotonin may reduce the severity of obsessive thoughts and compulsive behaviors in some individuals with OCD.

How Long Does it Take for Lexapro to Work on OCD?

The time it takes for Lexapro to take effect varies from person to person. However, in most individuals, the effect can take several weeks. Most individuals can begin to notice improvements after 2-4 weeks of treatment, while others may take up to 6-8 weeks.³ Because the effects are not immediately noticed, you might want to stop taking it, but it’s important to give it time.

Is Lexapro an Effective Treatment for OCD?

Lexapro can be an effective treatment for OCD in some individuals. Studies have shown that SSRIs can help reduce the symptoms of OCD by increasing serotonin in the brain. Studies looking specifically at Lexapro have shown that it can improve functioning and reduce OCD symptoms in some individuals.^{4, 5}

Other studies have demonstrated that Lexapro can decrease the risk of relapse of OCD symptoms compared to a placebo.⁶ These studies have also shown that Lexapro is typically well-tolerated with minimal side effects.

Is Lexapro the Best SSRI for OCD?

There are many SSRIs available on the market for the treatment of OCD. Some SSRIs, such as fluoxetine and sertraline, are FDA-approved for treating OCD. However, this does not necessarily mean these SSRIs will be more effective than Lexapro. Which SSRI works best varies from person to person and depends on several factors, including the person’s health history, potential side effects, and individual responses to medications.

Benefits & Risks of Lexapro for OCD

Lexapro offers many potential benefits as OCD treatment by reducing obsessive thoughts and compulsive behaviors in some individuals. These improvements can lead to a significantly improved quality of life and better daily functioning. However, there are potential risks and side effects associated with Lexapro. These side effects include nausea, insomnia, sexual dysfunction, and more.

Additionally, not everyone responds the same way to Lexapro, and it may take several weeks to see improvement in symptoms. Lexapro can also cause withdrawal symptoms if the medication is stopped abruptly. The decision to use Lexapro for OCD should be made in consultation with a healthcare provider to weigh these benefits and risks.

Lexapro and OCD-Related Disorders

Lexapro can be beneficial in cases where individuals with OCD also experience other conditions, such as depression or anxiety. Lexapro is an SSRI and helps regulate serotonin in the brain, which plays a major role in mood regulation. Anxiety and depression commonly co-occur in individuals with OCD. By addressing depression and anxiety symptoms, Lexapro can provide a comprehensive treatment for individuals with OCD. By improving overall mood and reducing anxiety, it can indirectly help with managing distress and impairment caused by OCD.

Side Effects of Lexapro for OCD

Although Lexapro is generally well-tolerated, it can cause side effects in many individuals. These side effects are often due to the medication’s impact on the brain’s and body’s serotonin levels. Many side effects are mild and resolve over time as the body adjusts to the medication.

Some side effects, however, can be severe or persistent, requiring adjustments in the dose of the medication or discontinuation of the medication altogether. Keeping your healthcare provider informed of all potential side effects you are experiencing is important to ensure the safe and effective use of Lexapro.

Common side effects of Lexapro include*:^{1, 3}

• Dry mouth
• Nausea
• Diarrhea
• Constipation
• Decreased appetite
• Insomnia
• Drowsiness
• Decreased libido
• Delayed ejaculation

*All medications, including Lexapro, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Serious side effects of Lexapro that require immediate medical attention include*:^{1, 7}

• Hallucinations
• Difficulty breathing or swallowing
• Swelling of the face, tongue, or throat
• Problems with thinking or concentrating
• Seizures

*All medications, including Lexapro, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Although Lexapro is typically well-tolerated, it is important to be aware of these potentially severe side effects. If severe side effects occur, it is necessary to seek immediate medical attention to lower the risk of serious long-term complications.

Lexapro for OCD Dosage

The dosage of Lexapro for treating OCD is determined by several factors that a prescriber must take into consideration. These factors include the person’s age, overall health, and response to the medication. Prescribers will most often start an individual on the lowest dose and gradually increase the dosage based on the individual’s response. Some studies have indicated that higher-dose Lexapro may be best for the treatment of OCD.⁴

How to Get a Prescription for Lexapro for OCD

When considering a medication such as Lexapro for the treatment of OCD, it is necessary first to have a comprehensive evaluation by a qualified healthcare provider. During this process, the healthcare provider will assess the severity of symptoms and coexisting conditions to determine the best treatment plan. While this can be done at an in-person visit, one option is working with an online psychiatry service. These services provide remote access to licensed psychiatrists and therapists who can assess, diagnose, and prescribe medications via a virtual consultation.

Alternative Medications for OCD

Lexapro is just one option for the treatment of OCD, but there are many other medications to consider. SSRI medications, such as Lexapro, are often the first medications to try when treating OCD. However, if SSRIs do not work for an individual, there are many other medications to try.

Alternative medications for OCD include:⁷

• Other SSRIs: Other SSRIs have been shown to be effective in treating OCD. These include citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline.
• Clomipramine: Clomipramine is a tricyclic antidepressant that works similarly to SSRIs and was the first drug used to treat OCD.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs have been shown to be similarly effective in treating OCD and are often more tolerable than clomipramine. SNRIs include venlafaxine and duloxetine.
• Other antidepressants: Other antidepressant medications may help with OCD symptoms but require more study. This includes agomelatine and mirtazapine.

Therapy Options for OCD

Lexapro can be most effective in managing OCD symptoms when used in conjunction with therapy. The most common therapy approach for OCD is cognitive behavioral therapy (CBT). CBT for OCD involves identifying and modifying thought patterns and behaviors associated with OCD. Therapists help individuals understand their obsessions and compulsions and teach them strategies to challenge and change these patterns.

Cognitive behavioral therapy for OCD includes:

• Psychoeducation: Before treatment, the therapist will educate the individual about OCD and explain how CBT will be helpful for treatment. This is an important part of treatment as it can help motivate the patient and prevent distress during the treatment process.
• Exposure response prevention therapy (ERP): ERP focuses on gradually exposing individuals to their obsessions or triggers while preventing the usual compulsive responses. This might occur in the form of repeated exposure to feared low-risk situations or through the imagined confrontation of these situations. This can help individuals learn to respond to obsessive thoughts and feared situations in a healthy way.
• Cognitive therapy: Cognitive therapy involves addressing inaccurate beliefs about obsessive thoughts and compulsion, helping patients address and change these beliefs.

FAQs About Using Lexapro for OCD

It is common for individuals to have questions and concerns when starting a new medication, such as Lexapro. Below are a few frequently asked questions and answers when treating OCD with Lexapro.

Is Lexapro Effective for OCD Symptoms?

The effectiveness of treating OCD symptoms varies from person to person. In one study, the risk of recurrence of symptoms decreased from 52% in the placebo group to 23% in those treated with Lexapro.⁶ Another study demonstrated that Lexapro at a higher dose led to significant improvements in all aspects of OCD functioning.⁵

Does Lexapro Stop Obsessive Thoughts?

While Lexapro may not stop obsessive thoughts completely, it can help reduce obsessive thoughts in individuals with OCD by decreasing the intensity and frequency of these thoughts.

Is Zoloft or Lexapro Better for OCD?

Zoloft (sertraline) is another SSRI medication commonly prescribed for the treatment of OCD. Both Zoloft and Lexapro are similarly effective in the treatment of OCD. The choice between them depends on how a person responds to the medication and any potential side effects.

Questions to Ask Your Healthcare Provider About Lexapro (Fluoxetine) for OCD

If you are considering using Lexapro for conditions such as OCD, it is essential to discuss this with your doctor, psychiatrist, and therapist. You may want to ask about how Lexapro works, its potential risks and benefits, and what to expect when you start taking the medication.

Questions to ask your care team when considering the side effects of Lexapro may include:

• Can I use Lexapro along with therapy to treat OCD?
• How long will it take for me to adjust to taking Lexapro?
• Am I at risk for more severe symptoms if I am already taking other psychotropic medications?
• What is the best dosage to ensure fewer side effects?
• Are there drugs I am taking that could have negative interactions?
• When should I reach out to you if I am experiencing side effects?
• Is there anything I should tell my therapist about this new medication?
• Are there any lifestyle or dietary considerations that may impact the effectiveness of Lexapro?
• What alternatives are there for the treatment of OCD?
• Is there a different medication that may work best based on my history?
• Can you provide resources or additional information to help me better understand Lexapro and OCD?

In My Experience

In my experience, Lexapro is a well-tolerated medication that offers many benefits. I see patients taking Lexapro for anxiety, depression, and OCD. I have seen firsthand the beneficial impact it has had on their quality of life. The patients seeking help for these problems are always happy that they did, and the most significant benefit often comes when using medication with therapy.