Prozac for OCD: Everything You Need to Know

How Does Prozac Help OCD?

Prozac mainly aids in reducing anxiety a patient develops due to the repetitive nature of OCD. When there isn’t enough serotonin, the brain cannot communicate efficiently. By boosting serotonin levels, a patient will experience an uplift in mood and feelings of general well-being. Once the symptoms of anxiety have been alleviated, Prozac empowers the patient to regain control over their thoughts and behaviors.

How Effective is Prozac for OCD?

Studies and placebo-controlled trials have found Prozac to be an effective and well-tolerated option for the treatment of OCD symptoms.³ It has been found to have a good safety profile, and any side effects experienced have rarely led to a person stopping their medication.³ Results are best seen with slow increases in the medication over a long period of time.^{3, 4}

How Quickly Does Prozac Work for OCD?

The full therapeutic effect of Prozac may take up to 5 weeks or longer to develop and can vary from person to person.¹ This means it will take time for results to be seen due to how the medication changes the brain chemistry. It is usually recommended SSRIs be taken for at least 12 weeks to review the desired result.⁵

Side Effects of Prozac

It is important to be aware of potential side effects when considering Prozac for the treatment of OCD. Many side effects of Prozac are mild to moderate and tend to go away within a few weeks of treatment. Some side effects may continue for a longer period of time. Clinical trials report insomnia, nausea, diarrhea, and sleepiness to be the most prevalent.¹

Common side effects of Prozac include:*¹

• Nausea
• Headache
• Trouble sleeping
• Nervousness
• Anxiety
• Feeling tired or weak
• Diarrhea

Serious side effects that require immediate medical attention include:*¹

• Suicidal thoughts and behaviors in children, adolescents, and young adults
• Serotonin syndrome
• Allergic reactions
• Seizures
• QT prolongation (an abnormal heart rhythm)

*All medications, including Prozac, 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.

Prozac for OCD Dosage

When prescribing Prozac for OCD, starting doses are observed and, if necessary, increased based on a patient’s needs. After initiating a starting dose of 20 mg per day in adults, the prescriber may consider a dose increase up to a maximum of 80 mg per day if symptoms do not improve enough after several weeks (usually 5+ weeks).¹

In children and adolescents, initial treatment of either 10mg or 20 mg per day may be followed by an increase in dose after two weeks. It’s not recommended to increase the dose beyond 20 mg per day in children and adolescents.¹

How to Get a Prescription for Prozac for OCD

While your primary doctor can prescribe Prozac for the treatment of your OCD, it is important to work with a care team (doctor, psychiatrist, and/or therapist) in order to get the best results. If you do not already have a care team, you may consider working with an online psychiatry service to be sure all providers are on the same page regarding your treatment.

Alternative Medications for OCD

Doctors typically choose treatments based on clinical research. Whether you need an alternative treatment is based on how you respond to your current treatment. When treating OCD, a patient generally starts behavioral therapy with or without SSRIs, such as Prozac.⁵

Alternative medications for OCD include:⁵

• Other selective serotonin reuptake inhibitors (SSRIs): SSRIs can help with the anxiety symptoms associated with OCD. What SSRI you take is based on many factors, such as preference, side effects, or possible interactions with other medications you take. Each patient is different in how they respond to medications. Examples of other SSRI medications include Lexapro (escitalopram), Zoloft (sertraline), Paxil (paroxetine), and Celexa (citalopram).⁵
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs are similar to SSRIs, but they also target another brain chemical called norepinephrine. Generally used if there is no response to SSRI treatment, an SNRI may have a better response in some patients based on their specific brain chemistry needs. An example of an SNRI approved to treat OCD is Effexor XR (venlafaxine).
• Tricyclic antidepressants (TCAs): TCAs are an older class of medication that also work by targeting serotonin and norepinephrine in the brain. The difference is these medications don’t target each chemical equally, whereas SNRIs do. By not being as selective in their targeting action, TCAs also have a larger range of side effects associated with them. An example of a TCA approved to treat OCD is Anafranil (clomipramine).⁵

Therapy Options for OCD

While Prozac is a good option for the treatment of OCD, better results have been seen when using behavioral therapy either before or in conjunction with medications. Treatment algorithms suggest behavioral therapy be used first and, should a response not be seen within 15-20 sessions, then add an SSRI like Prozac.⁵

Commonly used therapy options for OCD include:

• Cognitive behavioral therapy: CBT for OCD helps a patient identify patterns of thought that cause the anxiety that leads to their compulsions. Once the patient learns to identify and find patterns, they can then modify their actions to respond to the stimuli in a different manner.
• Exposure response prevention therapy (ERP): ERP helps a patient prevent themselves from engaging in their usual compulsion. It is done in a controlled environment where the patient is gradually exposed to anxiety-provoking situations, people, or objects that cause their compulsions.⁶ Exposure is then increased as the patient can cope with and tolerate these triggers.

FAQs About Using Prozac for OCD

It is understandable for patients to have questions or concerns regarding their medications.  Here are some common questions about using Prozac for OCD. Should you have further questions, please discuss them with your doctor or pharmacist.

How Long Should You Be On Prozac for OCD?

Due to the nature in which the medication increases the serotonin levels in the brain, it is expected to take up to an average of 5 weeks before you start to see benefits from Prozac. Be sure to give the medication time to reach its full therapeutic capacity, as this time frame can vary from person to person.

Can Prozac Worsen OCD?

It is not expected that Prozac would worsen the symptoms of your OCD. Some side effects of the medication may cause an increase in anxiety for a patient. However, most side effects associated with Prozac are temporary. If you feel as though Prozac has worsened your symptoms, it is best to speak with your doctor immediately to consider changing your course of treatment.

Does Prozac Stop Obsessive Thoughts?

Research has shown Prozac to be an effective medication in decreasing the obsessive thoughts commonly associated with OCD. This is based on scaling methods used in clinical studies to measure the intensity of obsessive thoughts both before and after treatment. Certain medications are not always effective for every patient. It is important to communicate with your doctor regarding any obsessions you may still be experiencing.

Is Zoloft or Prozac Better for OCD?

Both Zoloft and Prozac are approved SSRIs for the treatment of OCD. Since they both function in the same manner, it is not expected one is more effective than the other. However, as with any medication, results will vary.

Questions to Ask Your Healthcare Provider About Prozac for OCD

It is important to be familiar with your OCD treatment in regards to how it works,

how it can help, its side effects, and more. Here are some questions you should consider asking your care team (doctor, psychiatrist, or therapist).

• Can I use Prozac along with therapy to treat OCD?
• How long will it take for me to adjust to taking Prozac?
• Is there a risk of serious symptoms taking Prozac with psychotropic medications?
• Will a previous history of addiction make me more susceptible to dependency?
• 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?