Can Medication Make OCD Symptoms Worse?

medication

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Can medication make OCD worse? The answer is yes if the medication triggers doubt within you, and you choose to perform many reassuring compulsive behaviors.

For example, I once had a client prescribed Fluoxetine for OCD; he was experiencing horrible contamination fears and was doing daily rituals and constant compulsive behaviors to avoid germs. When he started the RIP-R treatment program (See Can This New OCD Treatment Help Where Others Fall Short?), he was not functioning well, so his psychiatrist prescribed him Prozac.

He was instructed to take the medication once a day. I checked in with this client through his behavior therapy and found that he was often not taking his medication. When I asked why he explained that he felt the bottle was "dirty," and if he touched the bottle, the "bottle dirt" would make his hands "dirty." Once his hands were "dirty," he "could not" pour the medication into his hands because that would make the medication "dirty," and he "can't ingest" something "dirty." He explained that even though he wanted to be medication compliant, he did not know how to get the medication inside of him.

That was an example of how a contamination OCD sufferer could be triggered. The medication can also trigger OCD sufferers from different subtypes. For instance, a harm OCD sufferer might want to use avoidance compulsions, should they have the "wrong" thought when they open the medication bottle.

One of my recent clients would not take her medication as prescribed because if she had a "bad" or "wrong" thought when opening the bottle, her OCD wanted her not to take the medication as not to "infect" herself. Thus, not following her psychiatrists’ recommendations. However, on days she had the "right" thought when opening the bottle, she could take the medicine.

Almost all OCD sufferers, regardless of subtype, compulsively google and research medications. Internet research is the main compulsion that people with medication uncertainty perform. The mere thought of putting a drug into their body is enough to trigger thoughts of uncertainty and doubt.

You might wonder, what is wrong with a person being informed, and doing their research? For the non-OCD / anxiety people, this should not be a problem. The issue with the anxiety / OCD community is the research never gives them “reassurance” or “satisfaction.” It just creates more questions, fear, and doubts. Thus, causing them to want to continue doing more research. Instead of feeling calm and confident, they end up feeling more fearful and doubtful.

Research compulsions trick their brain into thinking that the medication is riskier than what it is. Thereby making it extremely difficult for the sufferer to take the “risk” of taking the medication.

Additionally, one never knows what is on the internet. An OCD sufferer stumbling upon an autobiographical tale of some unknown person’s aunt allegedly having a “catastrophic” reaction to medication could send them into a full-blown panic. This could lead to the OCD sufferer not taking their medicine.

If an OCD sufferer is going through compulsive behaviors, then it might not matter if Prozac is in their system or not. Medication has been shown to increase a sufferer’s chance of recovering. However, if the sufferer is not going to take a chance, even with their medicine, their brain will not have an opportunity to perceive danger correctly. This could block the person from getting into OCD recovery. Similarly, even if a sufferer takes their medication regularly but still engage in unproductive compulsive behaviors, they may struggle with OCD recovery.

Like with all triggers, I advise clients to use medication as an opportunity to gather all their strength and courage, resist googling or seeking reassurance from loved ones, and all the other protective compulsions.

Hearing this is a huge pill to swallow, but taking the risk might lead to a free and OCD recovered life.