OCD medications control symptoms but do not “cure” the disorder, much like insulin does not “cure” diabetes, but rather, helps to manage symptoms. This means that the positive effects of an OCD medication only occur while the drug is being taken and some symptoms often remain, although with lower severity. When the child stops taking the OCD medication, symptoms usually return within a period of months.
No two children respond to anti-OCD medication in exactly the same way. In addition, an occasional child will not respond to any medication. It is common for children to have individualized responses to each of the anti-OCD medications. Some work well for a particular child, and some not at all. The occurrence of side effects also varies greatly. Because of this, it is impossible to pick ahead of time which medication will work the best for a particular child. It is important to understand that if the first medication chosen does not improve OCD, another one should be tried. Over time, the child may need a trial of each of the six available anti-OCD medications to find the one that works best.
[Visit IOCDF's OCD Treatment Guide for specific information on pediatric OCD medication]
All OCD medications work slowly. This can be frustrating for youth, families, and clinicians. It may take up to two to three months to see improvement. Also, ongoing further improvement of OCD may continue between twelve weeks to a year after starting medication.
Talking with Parents about Medication
Many parents are anxious about seeking psychiatric help for their child, especially when medication is recommended. Although most professionals will agree that exposure and response prevention (ERP) therapy should be tried first, a combination of ERP and medication is the best treatment in many cases, especially with moderate to severe symptoms.
Clinicians sometimes use the metaphor of “training wheels” with the child and the parents, as medication can often offer some relief from anxiety that enables the patient to engage in ERP therapy more readily.
Parents should be encouraged to make a pro and con list around the medication issue. Often times a child who is struggling with OCD may feel sad and depressed and may withdraw from social activities, peers, and family relationships. They may become consumed with their worries and exhausted by the energy it takes them to challenge their fears. The increased feelings of depression, helplessness, and hopelessness may have a more detrimental impact on psychosocial development and on school functioning. If the use of medication could halt this snowball effect of symptoms, then parents may decide to try it for initial relief of symptoms. Many young children make significant gains with behavior therapy once they have medication on board.