Table 27 Recommendations for pharmacotherapy for OCD

First-line

Escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline

Second-line

Citalopram, clomipramine, mirtazapine, venlafaxine XR

Third-line

IV citalopram, IV clomipramine, duloxetine, phenelzine, tramadol, tranylcypromine

Adjunctive therapy

First-line: aripiprazole, risperidone

Second-line: memantine, quetiapine, topiramate

Third-line: amisulpride, celecoxib, citalopram, granisetron, haloperidol, IV ketamine, mirtazapine, N-acetylcysteine, olanzapine, ondansetron, pindolol, pregabalin, riluzole, ziprasidone

Not recommended: buspirone, clonazepam, lithium, morphine

Not recommended

Clonazepam, clonidine, desipramine