Celexa (citalopram) is a type of selective serotonin reuptake inhibitor (SSRI) that can help reduce symptoms of obsessive compulsive disorder (OCD), and target co-occurring conditions—like anxiety, depression, and post-traumatic stress disorder (PTSD). Celexa can be effective on its own, but is especially impactful when used in conjunction with exposure and response prevention therapy (ERP), which targets the behaviors at the root of the OCD cycle.
When you have obsessive compulsive disorder (OCD), getting diagnosed and treated can be a journey. While OCD symptoms often begin in adolescence, it can take an average of 12 to 15 years to access treatment.
Luckily, OCD is highly treatable via two complementary treatments: medication and . exposure and response prevention therapy (ERP)—a specialized form of cognitive behavioral therapy designed for OCD, which works by gradually exposing you to your fears or triggers, and teaching you to resist compulsive behavior in the process. ERP therapy helps people learn to tolerate the discomfort and distress caused by their obsessive fears and often reduces OCD symptoms within a matter of weeks.
The other first-line treatment for OCD is medication. Among the medications commonly prescribed for OCD is citalopram, more commonly known by its brand name, Celexa. In this article, we’ll discuss how paroxetine works to treat OCD symptoms, what its common side effects are, and how it can be used alongside ERP to help you get back to living life on your own terms.
What is Obsessive-Compulsive Disorder (OCD)?
OCD is a mental health condition characterized by two symptoms: obsessions and compulsions. Obsessions are intrusive thoughts, sensations, images, feelings, or urges that cause intense distress or anxiety. These obsessions are recurrent and difficult to control. Common obsessions revolve around harm, sexuality, relationships, and contamination, among other themes. People with OCD often recognize that their obsessions are irrational, but struggle to dismiss or ignore them.
In response to obsessions, with OCD perform compulsions—repetitive acts or rituals meant to provide relief from distress and anxiety, or to attempt to prevent an unwanted outcome. Compulsions can be physical actions like excessive hand washing, arranging objects in a specific order, or mental rituals such as counting or praying. These rituals may temporarily relieve distress, but they do nothing to prevent obsessions from returning again, reinforcing a vicious cycle of obsessions and compulsions.
When OCD is left untreated, simple tasks like leaving the house, completing assignments, or making decisions can become arduous and time-consuming. This can lead people to become isolated and/or hopeless, contributing to a higher risk of other mental conditions—such as depression, anxiety disorders. Luckily, OCD can be treated with the right medications and therapeutic strategies.
What is Celexa (citalopram)?
Celexa (citalopram) is a medication that is part of a group of drugs known as a group of selective serotonin reuptake inhibitors (SSRIs)—along with Lexapro (escitalopram), Prozac (fluoxetine), Zoloft (sertraline), Luvox (fluvoxamine), and Paxil (paroxetine).
The immediate effect of SSRIs is to increase the amount of serotonin between nerve cells in certain parts of the brain. However, there is no conclusive evidence of a serotonin deficiency in people with OCD, so researchers are still working to understand exactly why SSRIs tend to reduce OCD symptoms. It’s likely that increased activity between nerve cells creates more gradual changes that lead to improvements in OCD symptoms.
SSRIs are also used to treat depression, generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD)—conditions that frequently co-occur with OCD. In this way, medications like Celexa can help you feel relief from other conditions that may be exacerbating OCD symptoms or inhibiting your ability to seek treatment for OCD.
Side effects and risks
It’s important to educate yourself on the potential side effects of Celexa. Many side effects are mild to moderate and tend to disappear within a few weeks, while others can persist for longer. Some of Celexa’s more common side effects include:
- dry mouth
- insomnia
- reduced sex drive
- nausea
- dizziness
- fatigue
- diarrhea
- constipation
- decreased appetite
- withdrawal symptoms if stopped abruptly
As is the case with all psychiatric medications, side effects may or may not impact you. You should discuss your individual needs and responses with your provider, and monitor your health carefully—especially during the first few weeks—to ensure that more serious side effects do not occur.
Treating OCD with Celexa
Extensive studies have demonstrated that Celexa and other SSRIs can be very effective at reducing OCD symptoms. In contrast to conditions like anxiety and depression, Celexa is usually prescribed at a higher dose for OCD. According to Jamie Feusner, MD, Professor of Psychiatry at the University of Toronto and Chief Medical Officer at NOCD, a daily 200mg or higher dose of Celexa is typical among OCD patients, whereas 100mg is typical for people with depression.
“At higher doses, it practically becomes a different drug, working on an entirely different area of the brain,” he explains. He notes that higher doses do not necessarily mean more severe side-effects. As always, monitor your health after taking a new medication and remain in communication with your provider if any side effects emerge.
While SSRIs like Celexa can be highly effective for OCD, these medications can take time to work. SSRIs typically reduce symptoms of anxiety and depression within two to four weeks, but it can take anywhere from six to 12 weeks to start reducing symptoms of OCD symptoms. Feusner says this is because “for OCD, on the time scale of six or eight weeks after treatment, there’s evidence that brain activity in the orbitofrontal cortex and caudate changes in response to medication, and that seems to relate to symptom improvement.” Lower doses of SSRIs used for anxiety and depression create changes in entirely different regions of the brain—a process which tends to happen in a shorter amount of time.
“In some cases, things continue to improve for many weeks or even months after that. Needless to say, this requires a lot of patience,” says Feusner. “There’s also a chance that Celexa might not work sufficiently, or at all for an individual, but we really have to wait for at least 12 weeks to make that assessment.” Feusner says at that point, a provider might recommend another type of SSRI, or another form of medication or treatment, entirely.
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Celexa and ERP therapy
ERP therapy can be a helpful tool while you wait for the benefits of medication to kick in. It can also support in cases where SSRIs are not provoking a sufficient response. ERP therapy helps people with OCD rewire the way they respond to obsessions, and learn to resist compulsions altogether. While medications, like Celexa, can treat the symptoms of OCD, ERP can create long lasting benefits that continue well beyond a course of treatment.
ERP therapy focuses on helping you confront your fears, anxieties, and triggers, while learning to resist engaging in compulsive behaviors. Through gradual exposures, a trained ERP therapist will help you learn to sit with discomfort, instead of immediately responding. ERP therapy can feel difficult, but it’s highly effective—and your therapist will work with you every step of the way to make sure you feel supported as you move through gradually more challenging exposures.
Often, medications like Celexa can help make the process of ERP therapy feel easier—or even possible. If you’re struggling with depression, for example, it may feel hard to find the motivation or energy to embark on ERP exercises. In other cases, anxiety levels may simply feel too high to tolerate exposures. SSRIs, like Celexa, can help target depression, anxiety, and the intensity of OCD symptoms, allowing you to engage more fully in treatment. In this way, medication and ERP therapy can be helpful complementary treatments for people navigating OCD.
It’s important to note that while you can treat OCD solely with Celexa, OCD symptoms will likely return if and when you discontinue medication. That being said, if Celexa’s side effects are not impacting you significantly, medication can be a long-term treatment option.
Bottom Line
Celexa, and other SSRIs, aren’t essential treatment options for every person living with OCD—but, they can make a big difference in reducing symptoms and targeting co-occurring conditions, like anxiety and depression. In many cases, medications like Celexa can give you the boost necessary to take on challenging therapeutic exercises, like ERP. It may take a while to feel the effects from Celexa, and side-effects can vary—so be sure to listen to your body, communicate with your provider, and practice patience. OCD recovery is not always quick or linear, but treatment is worth it. In time, you regain control over your life.
Key takeaways:
- Celexa (paroxetine) is an SSRI that can help reduce symptoms of OCD.
- SSRIs can also treat anxiety, depression, and PTSD—conditions that often occur alongside OCD.
- Medications like Celexa can help ease the process of ERP therapy, which teaches you how to face fears and anxieties while resisting compulsions.
- SSRIs tend to reduce symptoms for as long as they are taken, and may be used as a long-term method of treatment; however, side-effects can occur.