What is the best drug of choice for treating obsessive-compulsive disorder?

The best drug of choice for treating obsessive-compulsive disorder (OCD) is often considered to be clomipramine. Clomipramine is a tricyclic antidepressant that has shown significant efficacy in reducing the severity of obsessive-compulsive symptoms, and it has a strong body of evidence supporting its use specifically for OCD. This medication works by increasing the levels of serotonin, a neurotransmitter that plays a key role in mood regulation and anxiety, which is particularly relevant for disorders like OCD.

Clomipramine’s effectiveness can be attributed to its dual action: it not only addresses the compulsive behaviors but also the intrusive thoughts characteristic of OCD, making it a more comprehensive treatment option for many patients.

While other options, such as sertraline, fluoxetine, and paroxetine, are also effective for OCD and are selective serotonin reuptake inhibitors (SSRIs), clomipramine holds a historical precedent in psychopharmacology for its specific application in treating OCD symptoms. In clinical practice, SSRIs are generally well-tolerated and are commonly prescribed, but it is clomipramine’s established track record and potency in addressing OCD that makes it stand out as the drug of choice in some contexts.