Intrusive thought
Antidepressants which have been shown to be effective in treating OCD include fluvoxamine (trade name Luvox), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and clomipramine (Anafranil). Although SSRIs are known to be effective for OCD in general, there have been fewer studies on their effectiveness for intrusive thoughts. A retrospective chart review of patients with sexual symptoms treated with SSRIs showed the greatest improvement was in those with intrusive sexual obsessions typical of OCD. A study of ten patients with religious or blasphemous obsessions found that most patients responded to treatment with fluoxetine or clomipramine. Women with postpartum depression often have anxiety as well, and may need lower starting doses of SSRIs; they may not respond fully to the medication, and may benefit from adding cognitive behavioral or response prevention therapy.
Sertraline
Sertraline, sold under the trade name Zoloft among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is primarily used for major depressive disorder, obsessive–compulsive disorder, panic disorder, and social anxiety disorder. Effectiveness is similar to other antidepressants. Sertraline is taken by mouth.
Common side effects include diarrhea, sexual dysfunction, and troubles with sleep. Serious side effects include an increased risk of suicide in those less than 25 years old and serotonin syndrome. It is unclear whether use during pregnancy or breastfeeding is safe. It should not be used together with MAO inhibitor medication. Sertraline is believed to work by increasing serotonin effects in the brain.
Sertraline was approved for medical use in the United States in 1991 and initially sold by Pfizer. It is currently available as a generic medication. In the United States the wholesale cost is about 1.50 USD per month as of 2018. In 2016, it was the most prescribed psychiatric medication in the United States, with over 37 million prescriptions.
Sertraline is used for a number of conditions, including major depressive disorder (MDD), obsessive–compulsive disorder (OCD), body dysmorphic disorder (BDD), posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), panic disorder, and social anxiety disorder (SAD). It has also been used for premature ejaculation and vascular headaches but evidence of the effectiveness in treating those conditions is not robust. Sertraline is not approved for use in children except for those with OCD.