It’s an understatement that living with obsessive-compulsive disorder (OCD) can be challenging. People with OCD spend an average of 14-17 years suffering from it before they even receive a diagnosis—and then often struggle to find the proper treatment.
In an effort to get better, rather than losing more precious time to OCD, many people ask the question: Can alternative treatments, such as herbal remedies and supplements, work for OCD the way they sometimes help with other mental health conditions?
Let’s take a look at the science so you can walk away feeling informed about all your treatment options—whether they come from an over-the-counter (OTC) supplement bottle or a more traditional route.
OCD and natural remedies
A number of OTC supplements have been examined for their potential to treat OCD. St. John’s Wort, milk thistle, valerian root, and borage are among the herbal supplements that have been marketed as beneficial for OCD symptoms.
But despite marketing efforts, there’s limited definitive research on how well they’ll actually work on OCD symptoms. Keep in mind that this is an issue that goes beyond treating OCD. The supplement industry as a whole has exploded in the U.S., and dubious claims about “natural remedies” are everywhere. The fact remains that supplements have not been rigorously tested to prove their effectiveness.
“Some people think a supplement might be great because it’s labeled as ‘herbal’ or ‘organic,’ but none of these are regulated,” says therapist and NOCD’s Chief Clinical Officer Dr. Patrick McGrath.
Currently, there are no natural remedies or supplements that have been approved by the FDA to treat OCD. This makes it even more critical to do your research before turning to the supplement aisle for relief from your symptoms.
And although you don’t need a prescription to pick up a supplement, it’s always a good idea to tell your doctor you’re thinking about taking them. For one thing, certain supplements can change how other medications you may be taking impact you. Even if you’re not taking any prescription drugs that they may interact with, natural remedies can have a powerful effect on your brain and body—so you’ll want to make sure they don’t backfire and make OCD symptoms worse.
Most important to know: Regardless of any natural treatments you choose to take, exposure and response prevention therapy (ERP) remains the gold standard treatment for people with OCD. OCD is a serious and chronic mental health condition; once the OCD cycle is established, it can be hard to break out of. You do a compulsion to find relief from the distress caused by your obsession, and inevitably the obsession returns. This makes day-to-day activities challenging, if not totally impossible. The key to OCD treatment is breaking this cycle, which is done using ERP.
“I’m not saying that herbal remedies and supplements don’t work,” McGrath said. “But, I do think you need to try ERP or actively do ERP for OCD.”
Supplements for OCD: What the science says
Here’s a round-up of “natural remedies” that people have turned to in an attempt to reduce OCD symptoms, plus key facts and potential side-effects you should know about.
St. John’s Wort
St. John’s wort (Hypericum perforatum) is a flowering shrub most often used to treat depression. Products containing St. John’s wort can come in the form of capsules, teas, tablets, and liquid extracts.
While no one cause of OCD has been established, an imbalance in neurotransmitters are thought to play a role in OCD—with evidence that serotonin may be of particular importance. Since St. John’s Wort works as a reuptake inhibitor for serotonin—meaning it can help with an imbalance or deficiency—some research has focused on whether using the supplement can help with OCD symptoms.
Research is mixed. Some research found significant improvements in OCD symptoms; however, the reduction in symptoms for those who took St. John’s Wort was not different from those who received a placebo.
As for side effects, it can cause diarrhea, dizziness, trouble sleeping, restlessness, and skin tingling in some people.
Milk Thistle
Milk thistle (Silybum marianum) is a flowering herb with anti-inflammatory and antioxidant properties. Milk thistle extracts are widely used to protect the liver against toxins and control chronic liver diseases, and it’s also said to help with breast milk production and diabetes symptoms.
Studies (albeit on rats) revealed that milk thistle interacts with neurotransmitters, and may have a role in regulating mood disorders like anxiety and depression. One randomized controlled trial on milk thistle for OCD treatment was conducted in 2010 with 35 participants, and compared it to fluoxetine (Prozac). The results indicated no significant differences in treatment effects between milk thistle (600 mg/day) and fluoxetine.
But given the very small sample size, clinical efficacy of milk thistle was not clearly established.
What’s more, while you may think milk thistle is side-effect-free compared to a pharmaceutical such as Prozac, it can lead to adverse effects including gastrointestinal problems, headaches, skin reactions, and more.
N-Acetylcysteine (NAC)
NAC is FDA-approved for treating pneumonia, bronchitis, cystic fibrosis, and other conditions. By replenishing levels of glutathione, a powerful antioxidant in the body, NAC can protect cells from damage. Taken as a supplement, the amino acid was also found to reduce oxidative stress and inflammation that may contribute to certain mental health disorders.
As for whether it may be beneficial for OCD, in a 2006 case study, researchers found a significant improvement in OCD symptoms with the addition of NAC (3000 mg/day) compared to fluvoxamine—an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. However, a series of six case reports on patients with treatment-resistant severe OCD found that NAC (3000 mg/day) showed limited effectiveness. Translation: Evidence isn’t consistent enough to make a call on NAC for OCD.
Side effects of NAC include nausea, vomiting, diarrhea, gas, gastroesophageal reflux, and allergic reactions.
5-Hydroxytryptophan (HTP)
5-Hydroxytryptophan (5-HTP) is a chemical produced in the body from the amino acid tryptophan. As a supplement, 5-HTP is made from the seeds of an African plant called Griffonia simplicifolia.
HTP can help raise serotonin levels, which may have a positive effect on sleep, mood, anxiety, appetite, and pain sensation.
But before putting anything in your body that may increase serotonin, keep in mind that the exact link between serotonin and OCD is still largely unknown. What’s more, we don’t have conclusive studies about the benefits of 5-HTP for OCD.
And if you’re on an SSRI for treating OCD, you’ll need to be extra cautious. Combining tryptophan with an SSRI carries the risk of serotonin syndrome, a potentially life-threatening reaction that results from having too much serotonin in your body.
Other side effects of 5-HTP include heartburn, stomach pain, nausea, vomiting, and diarrhea.
Kava
Kava (Piper methysticum) is often taken for its mild calming effects, as it can help stimulate production of serotonin and gamma amino butyric acid (GABA), the neurotransmitter in charge of regulating anxiety and promoting relaxation. Kava can be taken as a drink or as a supplement or extract.
The plant has been used to alleviate symptoms related to depression, menopause, insomnia convulsions, and more. Although kava has been used in the treatment of general anxiety disorder (GAD), and some people have used it for OCD, there are limited studies on kava’s effects on OCD symptoms.
The most common side effects of kava include headache, dizziness, drowsiness, depression, diarrhea, and, in some cases, skin reactions.
Valerian root
The plant (Valeriana officinalis) is associated with the regulation of GABA, and it’s sometimes used by people trying to manage anxiety, insomnia, and migraines.
One double-blind study with 31 participants looked at valerian extract for treating OCD, and found that the plant was more effective than the placebo in alleviating OCD symptoms. But again: these results were only found in one study, which occurred in 2011.
That said, since sleep problems are commonly associated with OCD, your doctor can let you know if valerian root may be a helpful sleep aid—not a replacement for ERP.
Valerian is usually well-tolerated, but when side effects happen, they can include headache, stomach upset, and mental dullness.
Borage seed oil
Borage seed oil is derived from the seeds of the plant (Echium amoenum or Iranian borage).
Generally, borage has been marketed as an effective treatment for rheumatoid arthritis, diabetic neuropathy, atopic dermatitis, premenstrual syndrome, and symptoms related to menopause.
In a 2009 study with 24 participants, borage extract was compared with placebo in OCD treatment. While there was no significant difference between the groups in the first week, a significant difference occurred at week 4 and week 6, improving anxiety. However, there are limited OCD studies on borage.
Borage supplements tend to be associated with mild side effects, gas, bloating, and indigestion. Still, it’s best to wait for further research before considering borage seed oil an effective alternative treatment for OCD.
Vitamin D
Vitamin D plays a large role in overall health, but it can be challenging to absorb adequate levels—especially in the colder months. “While there is some anecdotal evidence suggesting that symptoms of OCD may worsen for some people during the winter months, the scientific literature on this topic is limited and inconclusive,” explains Nicholas Farrell, PhD, Director of Clinical Development and Programming at NOCD.
A 2017 study by Psychiatry Research Journal with participants of 52 children found that vitamin D levels were lower in patients with OCD. However, a 2018 study by the Nordic Journal of Psychiatry found that there were no significant differences in vitamin D in patients with or without OCD. Additionally, “one recent paper published in the Archives of Neuropsychiatry found that the severity of OCD symptoms did not show meaningful seasonal changes,” adds Farrell.
Again, Vitamin D may be necessary if you have a deficiency and your doctor recommends it, but we don’t have enough evidence to make the call on its role for OCD.
Vitamin B12
Vitamin B12 plays a role in producing brain chemicals that affect mood and other brain functions. For instance, low levels of B12 may be linked to depression.
One 2014 study found that vitamin B12 deficiency was significantly higher in patients with OCD. That said, other studies showed no significant differences between OCD and controlled groups.
Keep in mind, most people under the age of 50 meet their B12 requirement with diet, and supplementation likely won’t help if you don’t have a deficiency. However, if you’re over 50 or blood tests indicate you have trouble meeting your daily quote, a B12 supplement can be helpful for overall health. Vitamin B12 is generally safe, and it’s a water-soluble vitamin, meaning that your body excretes what you don’t need in your urine.
Just keep in mind that the jury is still out on whether it plays a meaningful role in OCD.
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Evidence-based treatment for OCD
As mentioned earlier, all of the supplements on this list are still being studied and haven’t resulted in any conclusive results suggesting that they can be a replacement for evidence-based treatment for OCD.
OCD is debilitating. And until you try treatment for OCD that has decades of clinical research behind it to prove its effectiveness, you haven’t given yourself the fair chance you deserve—to recover and live a life free from OCD’s grip.
So what is that treatment? Exposure and response prevention (ERP) therapy is an evidence-based treatment that is highly effective in helping people manage OCD; in fact, it was specifically designed to treat OCD.
ERP is unlike traditional talk therapy—there’s no analyzing and dissecting why you have obsessions and why you perform compulsions. Instead, you work with an ERP therapist to gradually expose yourself to your triggers and intrusive thoughts. The goal is to find new ways of responding to your obsessions—things that don’t involve compulsions.
Additionally, there are medications for OCD including SSRIs and tricyclic antidepressants (TCAs), such as fluoxetine, sertraline, and fluvoxamine—which are all FDA-approved. When therapy alone isn’t enough, sometimes adding medication to your ERP therapy plan is helpful.
Of course, if you’re reading this article, it may be because you’re looking for something “more natural” than pharmaceuticals. However, McGrath notes that just because something is natural doesn’t always mean it’s better. “I’m not saying that supplements don’t work, but there are other options like therapy that involve learning, failing, and trying. What is more natural than ERP?”