Zoloft or Prozac better for ocd?

[Anonymous]

My son has mostly moral OCD, constantly checking if he made the right decision. He also has a lot of intrusive thoughts that he confesses constantly. No one outside of immediate family members would guess he has OCD because he masks very well in public, at school, etc.
I am worried how much stress it’s putting on him mentally so I would like him to try an SSRI. I’ve been comparing which type would be better for the symptoms he’s experiencing specifically. Anyone who has experience with one or the other can you comment how they helped and how your OCD was affected when you were on the medication? Side effects like sleepiness and numbness I would also be interested in. Thank you. I’m very overwhelmed.

[Anonymous]

It’s very individual. Those two are the most studied in kids, so those are the ones they typically try first unless there is a family history of something else working well. Luvox is another one that is often tried with OCD because there is specific research with it and OCD.

[Anonymous]

FWIW my DD with OCD has done well on Zoloft. I like that it has a shorter half-life than Prozac so theoretically easier to wean off if necessary.

[Anonymous]

I have two DDs that have OCD tendencies. One is on Prozac and the other is on Zoloft. It really depends on the individual.

[Anonymous]

My 11 year old has been on Prozac for OCD since she was 9. They raised her dose a few times and she has been taking 60 mg for a while. We weren’t really given a choice of medication , the psychiatrist just said Prozac would be best for her. It has worked and taken away almost all of her compulsions. She was like a different kid when she started taking it. Her OCD is primarily magical thinking. She used to take it in the morning and that did make her tired in the middle of the day or after school , it was hard for her to stay awake so we had her start taking it in the evening after sports.

[Anonymous]

Zoloft but it usually needs to be a higher dose.

[Anonymous]

Op, it’s all trial and error on the meds. If you have family members who have had success with an SSRI, that might be a good place to start. My DC on Lexapro because two family members take it successfully and it’s been very very helpful.

My DC’s OCD symptoms are similar - wonders all the time if they are a good person, if they did something by wrong, etc. - mostly all intrusive thoughts, although when they did the YBOCs, realized they are also counting things, and have other compulsions.

The meds help, although my DC has moments where the compulsions are still terrible. DC is still in therapy as it’s become clear that meds are just part of the solution.

To be honest, DC started on Lexapro, things got better but not great and psychiatrist decided to trial Prozac. DC did not operate that well - got very very hyper and impulsive, so trialed Zoloft, which also made them hyper and impulsive. I asked for DC to go back to Lexapro, which wasn’t as effective as I hopes but DC does not have any side effects that I know of and it does help.

Good luck on the medication, and it can be very helpful!

[Anonymous]

My DD started on Zoloft for OCD but we switched her to Prozac which has worked well. She is now up to 60mg daily on Prozac. It isn't perfect but really helps. In retrospect we never titrated the Zoloft up high enough to really see effects with OCD and stopped it prematurely because of perceived weight gain and fear that side effects outweighed benefits.

[Anonymous]

I'm an OCD therapist. The issue with SSRIs for OCD is that they are "supposed" to be at the highest possible dosages, as in that's what is evidence based. Meaning like 200mg. That's a lot for a young person to tolerate, so don't be discouraged if they try the meds and the side effects are too difficult. ERP works wonders.

[Anonymous]

Anonymous wrote:I'm an OCD therapist. The issue with SSRIs for OCD is that they are "supposed" to be at the highest possible dosages, as in that's what is evidence based. Meaning like 200mg. That's a lot for a young person to tolerate, so don't be discouraged if they try the meds and the side effects are too difficult. ERP works wonders.

But our neuropsychologist said ERP is cruel and torturous unless the child is medicated. Is this true in your experience as an OCD therapist ?
-OP

[Anonymous]

Prozac worked for both me and my child, and we did need higher doses. Zoloft did not work for me at all. Be willing to try different doses and switch to the other if the doctor so advises. It’s a horrible thing to live with, but the meds take the edge off while you work with a therapist. Good luck.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm an OCD therapist. The issue with SSRIs for OCD is that they are "supposed" to be at the highest possible dosages, as in that's what is evidence based. Meaning like 200mg. That's a lot for a young person to tolerate, so don't be discouraged if they try the meds and the side effects are too difficult. ERP works wonders.

But our neuropsychologist said ERP is cruel and torturous unless the child is medicated. Is this true in your experience as an OCD therapist ?
-OP

What? It’s strange for me to hear this because ERP was a life-saver for our DD when she first had severe symptoms at 6 years old.

[Anonymous]

PP here - DD didn’t go on medication until she was 9. She didn’t need medication to improve with ERP initially.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm an OCD therapist. The issue with SSRIs for OCD is that they are "supposed" to be at the highest possible dosages, as in that's what is evidence based. Meaning like 200mg. That's a lot for a young person to tolerate, so don't be discouraged if they try the meds and the side effects are too difficult. ERP works wonders.

But our neuropsychologist said ERP is cruel and torturous unless the child is medicated. Is this true in your experience as an OCD therapist ?
-OP

I’m not this therapist, but ERP either with or without meds is absolutely going to be a part of treatment for OCD.

My DC started ERP without meds and didn’t make much progress until meds were added. We did ERP for almost a year because I was really hopeful it would help enough and I was very nervous about trying an SSRI.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm an OCD therapist. The issue with SSRIs for OCD is that they are "supposed" to be at the highest possible dosages, as in that's what is evidence based. Meaning like 200mg. That's a lot for a young person to tolerate, so don't be discouraged if they try the meds and the side effects are too difficult. ERP works wonders.

But our neuropsychologist said ERP is cruel and torturous unless the child is medicated. Is this true in your experience as an OCD therapist ?
-OP

It’s not if you go to an experienced clinician who knows how to pace it. Yes, confronting your fears is the basis of it, but you go slowly and methodically. I agree that meds make it easier, but if the meds aren’t working or can’t be used for some reason, ERP is still the gold standard treatment.