Although benzodiazepines are a commonly prescribed medication, they typically aren’t used to treat obsessive-compulsive disorder because they can worsen the condition.
Article at a Glance:
Benzodiazepines are not used as standard therapy for obsessive-compulsive disorder (OCD) because they do not have proven effectiveness.
Benzodiazepines have many different side effects that can worsen OCD.
The primary medications used to treat OCD include SSRIs.
If a person has both OCD and benzodiazepine addiction, their conditions can be hard to treat without specialized care.
Commonly Prescribed Benzodiazepines for OCD
Benzodiazepines are typically used to treat symptoms of anxiety. Obsessive-compulsive disorder (OCD) can cause anxiety, but other medications are typically used to treat this condition because benzos can worsen other OCD symptoms.
Some commonly used benzodiazepines include Xanax, Ativan, Valium and Klonopin. The following overview discusses how these drugs can impact OCD symptoms.
Xanax is a fast-acting medication used to treat anxiety symptoms and panic attacks. Although Xanax is a legal medication, it can be easily abused and is highly addictive. Patients with OCD are not usually prescribed Xanax unless other medications have been ineffective.
Xanax can create additional problems for people with OCD. Abuse or long-term use of Xanax can increase the risk of addiction, medically called a substance use disorder. The presence of a substance use disorder on top of a mental health disorder like OCD is called a co-occurring disorder.
Ativan, another benzodiazepine medication similar to Xanax, is primarily used for the treatment of anxiety or seizures. Because anxiety usually accompanies OCD, Ativan may help reduce the anxiety associated with OCD. Like other benzos, however, Ativan has a high potential for addiction and abuse.
Even though Ativan helps with anxiety symptoms, it does not provide relief for other OCD symptoms. For this reason, other medications are better suited for treating OCD.
Like other benzodiazepine medications, Valium does not help treat OCD. Instead, it may provide temporary relief and reduce symptoms until proper treatment is sought. Valium can offer short-term relief from many anxious feelings but has a high potential for abuse and addiction.
Klonopin is another benzodiazepine medication used to treat panic disorder and seizure disorders. However, Klonopin should not be prescribed to treat OCD due to the medication’s addictive potential. A person with addiction will experience withdrawal symptoms when they stop taking the drug, and benzos have many different withdrawal symptoms that can trigger OCD symptoms.
Which Drug Should I Try First for Treatment of OCD?
Drugs with the most evidence to support their use in OCD treatment include selective serotonin reuptake inhibitors (SSRIs) and some tricyclic antidepressants (TCAs).
SSRIs include:
- Celexa (citalopram)
- Lexapro (escitalopram)
- Prozac (fluoxetine)
- Luvox (fluvoxamine)
- Zoloft (sertraline)
- Paxil (paroxetine)
Clomipramine is the only TCA that may be effective for OCD, but it is sedating and would probably only be used if the SSRI failed. It could be used in addition to an SSRI.
When Are Benzos Prescribed for OCD?
Benzodiazepines are not prescribed to patients with OCD because the evidence does not support their use. They have not been proven to be safe or effective in treating OCD and any of its symptoms (More on SSRIs).
Although psychiatric professionals do not support benzo treatment for OCD, a recent study found that up to 38.4% of people with the condition have used benzos.
Are There Side Effects?
Common side effects of benzos may include:
- Confusion
- Diarrhea
- Drowsiness
- Headache
- Respiratory arrest (stopped breathing)
- Respiratory depression (slowed breathing)
- Fainting
- Tremors
The above side effects could potentially worsen OCD and its symptoms.
Continue reading at Signs, Symptoms & Side Effects of Benzodiazepine Abuse →
Who Should Not Take These Medications?
People who only need treatment for OCD should not be prescribed these medications. In addition, people with a history of substance use disorder and women who are pregnant or breastfeeding should not use these drugs.
Medications for OCD and Anxiety
Anti-anxiety medications and antidepressants, such as SSRIs, are commonly prescribed for OCD and other anxiety disorders. SSRIs are the primary medication for OCD because the condition is caused by obsessive thoughts that may worsen and drive anxiety.
For people with OCD, anxious and obsessive thoughts are poorly managed by compulsive behaviors. For example, a person may have a fear of germs that causes them distress and anxiety, and they obsess over these thoughts. They may then participate in the compulsive behavior of washing their hands until their skin is red and raw. SSRIs work by managing the anxiety associated with obsessive thought and breaking the OCD cycle.
FAQs About OCD
SSRIs are the drug of choice for OCD treatment. These are long-term, daily medications that act on the underlying anxiety symptoms that drive OCD.
Stimulants that are commonly approved to treat ADHD can worsen OCD. Additionally, any substance of abuse has the potential to worsen the condition.
The relationship between SSRIs and the human brain is complex, and there is no one clear answer for everyone. Someone with OCD may need to try a few different medications to discover which one works best for them.
It depends, but an SSRI may be stopped if OCD symptoms can be managed effectively with other treatments. Other techniques for treating OCD include psychotherapy, deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS).
What if I am afraid to take my medication because I have an obsessional fear of drugs?
OCD and anxiety are caused by a combination of genetic and environmental factors. Compulsive behavior is learned as a coping mechanism for obsessions.
OCD and anxiety can be treated with a variety of methods, including a form of psychotherapy called cognitive behavioral therapy (CBT). CBT helps people reframe their current behavior and learn new coping mechanisms that are not harmful to their lives.
The most effective strategy for treating OCD and substance abuse is a combination of medication and therapy. If you or someone you know is living with OCD and a co-occurring addiction, The Recovery Village offers dual diagnosis treatment delivered by experienced mental health professionals. Contact us to speak to a representative and begin the recovery process today.
Related Topics:
Obsessive rumination disorder treatment
Bounds, C., et al. “Benzodiazepines.” StatPearls, November 22, 2020. Accessed October 6, 2021.
Bostwick, J. “Benzodiazepines: A versatile clinical tool.” Current Psychiatry, April 2012. Accessed October 6, 2021.
University of Florida Department of Psychology. “Medications for OCD.” Accessed October 12, 2021.
Starcevic, Vladan; et al. “Use of benzodiazepines in obsessive-compulsive disorder.” International Clinical Psychopharmacology, January 2016. Accessed October 6, 2021.
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