What Is the Best Medication for OCD?

There’s no single best medication for OCD. The medications most often recommended are SSRIs (selective serotonin reuptake inhibitors) and, in some cases, clomipramine. Which one suits you depends on side effects, your other health conditions and how you’ve responded to medication before. I’m a psychotherapist, not a prescriber, so that decision belongs with a physician or psychiatrist.

Which medications are used for OCD?

The medications used most for OCD are SSRIs, and in some cases clomipramine, an older tricyclic antidepressant. SSRIs often used for OCD include fluoxetine, sertraline, fluvoxamine, paroxetine, and citalopram or escitalopram.

For OCD, higher doses tend to work better than lower ones, though they bring more side effects (Bloch, 2010), and the benefit often takes several weeks or longer to show, so give it time with your doctor. I won’t tell you which one to take or how much. That’s not my job, and it shouldn’t be any therapist’s. One thing worth knowing going in: about half of people don’t respond to their first SSRI, so changing the dose or the medication is common, not a failure (Abramowitz, 2026).

Should you take medication, do ERP, or both?

That depends on your symptoms, your history and what you can access, and it’s a decision to make with your doctor. Many people take medication alongside Exposure and Response Prevention (ERP). In trials, adding medication to CBT did not reliably beat CBT alone (Öst, 2015), but medication helps many people, especially when ERP is hard to access or symptoms are severe. A 2026 BMJ review reached the same conclusion: ERP plus medication did about as well as ERP alone, and better than medication alone (Abramowitz, 2026). The full order of treatments is on OCD treatment in 2026: what works, and newer options are compared on TMS vs ketamine vs psilocybin for OCD.

Medication and ERP do different jobs. ERP is where you practise facing the thought without the ritual. It’s just reps. If you’re not sure how severe your OCD is, how to tell if OCD is severe is a good place to start, and whether OCD ever goes away covers what treatment aims for.

What should you ask your doctor about OCD medication?

Ask how the medication is meant to help your OCD specifically, how long to give it, and what to do about side effects. A few questions worth bringing:

• How will we know whether it’s helping my OCD, and when will we review it?
• What side effects should I watch for, and what do I do if they show up?
• Can you refer me for ERP, or work with my therapist?
• If I want to stop one day, what would that plan look like?

In Ontario, your family doctor is usually the first stop. The Ontario OCD treatment guide lays out public and private routes, and whether OHIP covers OCD therapy explains what’s publicly funded.

Frequently asked questions

Can I do ERP while taking medication?

Yes, many people do. Medication and ERP do different jobs, and in trials, adding medication to CBT did not reliably beat CBT alone (Öst, 2015). Some people find medication makes it easier to start exposures.

Will I have to take medication forever?

Not necessarily, and that’s a question for your prescriber. In one trial, 12 weeks after treatment ended, 45% of people who had responded to clomipramine alone relapsed, compared with 12% after ERP (Simpson, 2004). Never stop or change a medication without talking to the doctor who prescribed it.

Can a psychotherapist prescribe medication for OCD?

No. Registered Psychotherapists in Ontario don’t prescribe. Medication is prescribed by a physician, such as your family doctor or a psychiatrist, and a therapist can work alongside them.