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15 min read

Is Prozac for OCD a good choice? What you need to know

Written by Dr. Geralyn Dexter

Published: Mar 4, 2024

Medically Reviewed by Goldina Erowele, PharmD, MBA

Table of contents

If you’re managing obsessive-compulsive disorder (OCD), you may be weighing your options and trying to determine the best treatment for you. Medications for OCD, like Prozac (fluoxetine) are one of the treatment options. Prozac is often prescribed for OCD and can help you regain control over your obsessive thoughts and compulsions.

This article helps you gives you information on how Prozac works as an OCD medication, dosing, side effects, and what the research says about Prozac for OCD, and more. After reading this, you’ll be equipped with the information you need to explore this treatment option with your healthcare provider.

What is Prozac?

Prozac (fluoxetine) is an antidepressant that belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). Serotonin is a neurotransmitter that regulates mood, sleep, digestion, and more. And Prozac helps increase serotonin activity in your brain. 

Prozac is used to treat disorders, such as major depressive disorder, panic disorder, and bulimia nervosa. The Food and Drug Administration (FDA) has approved Prozac for acute and maintenance treatment of OCD as well, and many studies support its effectiveness. 

What is OCD?

OCD is a mental health condition characterized by recurrent, unpleasant thoughts or obsessions, along with compulsive behaviors aimed at relieving distress related to obsessions. These obsessions and compulsions are more than routine fears or behaviors, they’re intrusive and upsetting. 

Obsessions and compulsions can impact daily tasks and relationships and affect quality of life. Every person experiences OCD differently, and there are different types of OCD (for example, contamination OCD or rumination OCD). Symptoms can include compulsive cleaning, frequent inspection of locks and appliances, self-harm, and many other unsupported anxieties.

Although the exact cause of OCD is unknown, a combination of environmental, behavioral, neurological, genetic, and cognitive variables are thought to be involved.

The recommended first-line therapies for OCD are cognitive behavior therapy, specifically exposure and response prevention, and/or an SSRI, such as Prozac.

How is OCD treated with Prozac?

Prozac increases serotonin levels in the brain. Serotonin is usually released and then reabsorbed into the brain’s neurons. An SSRI, like Prozac, blocks the reabsorption (or reuptake) of serotonin, so more serotonin stays between neurons. This helps reduce the intensity of OCD’s obsessions and compulsions. Increased serotonin helps reduce the anxiety and distress caused by the obsession-compulsion cycle. It’s important to remember that, like any medication, the effectiveness of Prozac may vary from person to person. 

People with OCD may also suffer from depression. Because Prozac is an effective medication for depression, it treats both OCD and symptoms of depression and anxiety disorder and offers help for both.

Does Prozac work for OCD?

Numerous research studies have looked at the effectiveness of Prozac for OCD and support its use as a therapeutic option. Its effectiveness comes from its ability to raise serotonin levels in the brain, which has the potential to lessen OCD symptoms.

A study published in Current Neuropharmacology reviewed developments in medication management for OCD over 10 years. The analysis found that Prozac is safe for adults, and improves quality of life, psychosocial functioning, and reduces obsessive thoughts and compulsions.

In another study published in Frontiers in Psychology, researchers completed a systematic review and meta-analysis that examined first-line treatments for OCD in adolescents and children. The study revealed that Prozac appears to be better than medications like Luvox (fluvoxamine) for the treatment of OCD. 

As important as medical research , people who take Prozac say it helps. Reviews of Prozac on give an average rating of 8.1 out of 10 from a total of 109 reviews for the treatment of OCD. 77% of reviewers reported a positive experience, while 14% reported a negative experience. And people taking it reported experiencing significant positive impacts on their lives, including reduction in obsessions and compulsions, and overall improvement in mood. 

What does Prozac do?

The primary way Prozac helps regulate mood is by affecting serotonin levels in the brain, a crucial neurotransmitter, more accessible in the brain. Serotonin can help lessen the frequency and intensity of intrusive thoughts by modulating the brain pathways linked to anxiety and obsessive thoughts. By increasing the brain’s serotonin levels, people with OCD can gain greater control over their compulsions as the resulting obsessive behaviors become less overwhelming and easier to manage or avoid. 

What’s the best Prozac dose for OCD?

To find the best Prozac dose for OCD, your provider will consider several factors, such as your age, the intensity, frequency, and duration of your symptoms, and how well you respond to the medication. 

Your provider will start you with a lower dose of Prozac. Starting doses may be 10 milligrams or 20 milligrams a day. The dose may be progressively increased. Your provider will determine how much and how often to adjust your medication based on your reaction and tolerance, especially if you need a higher dose. Typical doses range from 20 to 60 milligrams a day. The highest recommended dose of Prozac for OCD treatment is 80 milligrams a day. 

Starting doseTypical doseMaximum dose
Prozac dosing10 mg–20 mg/day20–60 mg/day80 mg/day

How long does Prozac take to work for OCD?

When Prozac starts relieving OCD symptoms varies from person to person. Some people begin to see results in the first few weeks. Typically though, it takes 2 to 4 weeks before people start to see improvements in mood and anxiety. 

If you take Prozac consistently, you may start seeing notable decreases in OCD symptoms between 8 and 12 weeks. Keeping track of your symptoms and sharing the information with your provider lets you track your progress and helps your provider better support you with therapy interventions and/or adjustments to your medication. 

How is Prozac taken?

Prozac is taken orally and is available in a tablet, capsule, or liquid. Your provider will tell you to take the medication daily at the same time for it to have the optimal therapeutic effect. 

The primary guidelines for taking Prozac include: 

  • Timing: Depending on your needs or the advice of your healthcare practitioner, you can take Prozac in the morning or the evening. This flexibility is helpful if you have side effects like insomnia or sleepiness. The key to maintaining steady drug levels in your system is to take it at the same time every day.
  • With or without food: You can take Prozac with or without food. Some people prefer to take it with food to reduce adverse gastrointestinal effects like nausea or upset stomach. 
  • Consistency: Sticking to a consistent schedule ensures the most consistent therapeutic effect. Taking your medication at the same time every day can also help reduce the possibility of missing a dose, which can negatively impact effectiveness. 

What side effects does Prozac have?

Similar to other drugs, Prozac can have adverse effects. They don’t affect everyone, and they may affect each person differently. Most side effects decrease as your body adjusts to the medication, which may take a few weeks. 

Before starting a new medication, your provider will discuss potential side effects. It can also be helpful to ask your provider about the best steps to take if you experience some of the more severe adverse side effects that can happen when taking Prozac. 

Common side effects of Prozac include: 

  • Nausea
  • Headaches
  • Drowsiness or insomnia
  • Anxiety or nervousness
  • Dry mouth
  • Loss of appetite or weight changes
  • Increased sweating

Like with other medications, there is the potential for serious side effects with Prozac, such as:

  • Difficulty breathing or swallowing
  • Hives or rash
  • Dizziness or fainting
  • Changes in heartbeat (for example, fast, slow, irregular) 
  • Seizures
  • Suicidal thoughts

It’s important to note that Prozac comes with a box warning, due to the potential to increase suicidal thoughts for some people, including adolescents and children. If you have a history of suicidal thoughts, talk to your provider before starting Prozac for OCD. If you’re taking Prozac and start having suicidal thoughts, seek crisis support immediately and reach out to your doctor as soon as possible.

If you stop taking Prozac, especially abruptly, you may experience withdrawal symptoms. Keep reading to learn more about what happens when you discontinue Prozac. 

What to know when considering Prozac

When thinking about starting Prozac, know that it’s one treatment option for OCD. While it can be effective, it’s important to talk with your doctor about your symptoms and medical history to make sure it’s the best choice for you. 

What to avoid when taking Prozac

Some medications or substances can interact negatively with Prozac, including the following: 

  • Alcohol can intensify side effects, such as sleepiness and dizziness.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) and blood thinners may make bleeding more likely.
  • Additional SSRIs or monoamine oxidase inhibitors (MAOIs), another class of antidepressants, may increase the possibility of serotonin syndrome, where an excess of serotonin accumulates between brain synapses. Too much serotonin can lead to confusion, rapid heartbeat, vomiting, and, in some cases, be life-threatening. 

Who shouldn’t take Prozac?

Prozac may not benefit everyone. People who have specific medical conditions or are taking certain medications may not be prescribed Prozac because it might make other symptoms worse or interact with other medications. 

People who are taking MAOIs, such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), or selegiline (Emsam), or have taken them in the previous 14 days should let their provider know before starting Prozac to avoid an increase in levels of serotonin and potentially serotonin syndrome.

If you’ve been diagnosed with bipolar disorder, tell your provider if you’re discussing Prozac as a treatment option for OCD. In some instances, antidepressants like Prozac may trigger manic episodes. 

People who have previously experienced severe adverse responses to fluoxetine or other SSRIs shouldn’t take Prozac. 

What happens if you stop Prozac?

Discontinuing Prozac suddenly can lead to withdrawal symptoms, such as dizziness, headache, irritability, and sleep disturbances. It’s important to taper off Prozac rather than abruptly stop taking it. If you’re considering stopping your medication, talk to your healthcare provider so, together, you can plan to taper off the drug safely and monitor your progress. 

What other OCD medications help?

Other drugs can effectively treat OCD, including: 

  • Other SSRIs, like Lexapro (escitalopram), Luvox (fluvoxamine), or Zoloft (sertraline). Tricyclic antidepressants (TCAs), such as Anafranil (clomipramine). 

In some cases, when symptoms don’t respond to antidepressants alone, atypical antipsychotics, such as Abilify (aripiprazole), may be prescribed in addition to antidepressants. 

Communicating openly with your provider about your symptoms and medications is the best way to ensure you’re taking the right medication at the right dosage. 

Does therapy help OCD?

Some people may be able to better manage the obsessive thoughts and compulsions of OCD with therapy alone. And combining therapy with medication, such as Prozac, can be more beneficial than either individual treatment option.

For the treatment of OCD, cognitive behavioral therapy (CBT), in particular exposure and response prevention (ERP), which is regarded as the gold standard treatment for OCD therapy, are beneficial. 

Additionally, dialectical behavior therapy (DBT) can be helpful for enhancing emotional regulation and managing distress. 

How to get a prescription for Prozac

You need to take a few steps before getting a prescription for Prozac for OCD. First, you need to see a licensed provider who can assess your symptoms and how they affect your day-to-day functioning. Finding out if what you’re dealing with is OCD is the first step. 

Next, you want to talk to your provider about the best treatment options based on your symptoms. If you’re experiencing obsessive thoughts and compulsions that cause significant disruption to your daily life, your provider may suggest medications like Prozac. 

After you start taking Prozac for OCD, your provider will schedule follow-up appointments to assess how you’re doing on the medication. These appointments are essential, as they create opportunities to talk about what’s working, what’s not, and how you feel. Your provider may also modify your dose as needed. 

Key takeaways

For many people struggling with OCD, Prozac is an effective option to reduce symptoms. Prozac is a proven treatment for OCD that can help people manage obsessive and intrusive thoughts and compulsive behaviors. Every person experiences OCD differently. Collaborating with your provider by being open about your symptoms and their impact on your daily life is a great way to find out if Prozac or other treatment options might be a good choice for you. 

Find a telehealth provider for a Prozac prescription for OCD (or Prozac alternatives) 

Are you prepared to take action to manage your OCD? If so, Klarity is a great place to start. 

Through Klarity, you can find an independent provider who can assess your symptoms and help you decide if Prozac or a different treatment option is right for you. Find a provider today and work toward gaining control over your OCD symptoms.

The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health.

If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.

How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.

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