OCD - Obsessive Compulsive Disorder/OCD meds


I have anxiety and OCD.  My OCD is primarily with keeping parts of my home spotlessly clean and organized. More than anything, I have the need to keep counters and the wood floors of the kitchen and high traffic areas crumb and dust free, by frequently wiping counter, vacuuming and dust-mopping the floors.  I'm 53 now and my issues started about 10 years ago but have gotten worse over time.

I've seen various psychiatrists and psycologist over these years.  I've been on various meds including Prozac, Zoloft and now Paxil.  These seems to stabilize my anxiety somewhat but none of them help with the OCD.  

My last psycologist suggested anafranil, which she said was an older medication but has been proven to help with OCD.   But when I asked my psychiatrist about putting me on that, he refused. I forgot the reason but basically he didn't believe in that med.  he put me on Paxil which I'm currently taking.

I did an internet search on anafranil, and unlike the other meds, it shows that it's primary use is for OCD.

I wonder why that psychiatrist refused anafranil.   Do you know why that might be?  Does it have any I negative serious effects?  The other meds all have side effects, so I am confused.  I am desperate to try something else as none of the meds or counseling I've had is working.

Hi Irene,

thanks for your question. Sorry to hear about your experience with anxiety and OCD over the years.

I'm not entirely sure what your psychiatrist's basis is for rejecting Anafranil. As you say, it may be more of a subjective opinion he might have. He might also have seen poor results with it in his past patients, or in particular samples of the medical literature.

But it seems more likely that his persuasion leans toward SSRI meds (such as Zoloft and Paxil), as opposed to tricyclic antidepressants, (such as Clomipramine in Anafranil). As your last psychologist said, anafranil is somewhat considered "old school", and SSRI's are increasingly phasing TCA's out (and other older meds) in the medical field. While they too have side-effects, they're generally considered less diverse over the population and less severe than medications in the TCA range.

However, there's little doubt that many individuals have responded well to Clomipramine (i.e. Anafranil), with minimal side-effects. And many reports of the drug have been highly favorable to OCD (as you say, that's its primary use). If you think it might be for you, you might want to discuss this option with another doctor.

I don't give advice on which medications to take, but it may be a good idea to trial the medication your psychiatrist prescribed - the Paxil - first. SSRI's can take a few weeks to a couple of months to notice therapeutic benefits, and it may be end up being the most efficacious out of the lot.

And you did not ask a question in this area, but with the counselling I'd probably recommend to you a behavioral therapy called ERP (Exposure & Ritual/response prevention) for your type of OCD (which seems to be predominantly contamination/orderliness/cleanliness). You can check the CBT registrar in your country of origin, for a suitably qualified therapist.

Feel free to share any further followup questions or comments you have. And a warm good luck. OCD is a horrible illness. I know it's tough. But stay strong. I know from personal experience that you can beat it with the right treatment and lots of determination.

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OCD - Obsessive Compulsive Disorder

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Alan Baker


I can answer questions relating to OCD, such as:

*Order & Symmetry
*Gender Identity
*Magical thinking/superstitions

Please note: I can not give you a diagnosis or give you medical advice. I also do not offer therapy or counselling. I advise you to see a doctor or mental-health professional for appropriate treatment of OCD.


I've been a research associate in clinical psychology, written numerous essays on OCD diagnosis & treatment, and been quite active in the local OCD community (as we do group-therapy and workshops). I also consider myself an ex-sufferer of OCD.

B.A Science
PGDip Applied Psychology
Social Work

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