Common Physical Side Effects
Unfortunately, virtually all medications come with the possibility of side effects. You might not have any, or those you do experience may be temporary or very mild. You will need to talk with your doctor before taking any medication to find out exactly what the potential side effects might be.
Many so-called “nuisance” side effects go away within the first few weeks. Others may diminish over months as your body becomes used to the medication. Side effects are by no means certain to occur. Some people do not experience any. Others experience symptoms that can be managed easily or are mild enough to cause no significant discomfort.
If you do experience side effects, but find that yours are fairly minimal, you may want to “tough it out” to give the medication a chance to work. Otherwise, schedule an appointment with your doctor as soon as possible so that you can plan your next step. Do not allow a brief setback to discourage you from pursuing treatment once you have begun to move forward in dealing with your OCD.
Headaches are a fairly common side effect of medication. However, they often diminish, if not disappear entirely, as one's body adjusts to the medication. Most headaches can be treated with standard over-the-counter remedies. There are also relaxation exercises that may help.
Non-Medicinal Headache Cure
One technique that seems to work remarkably well on headaches (as well as other kinds of pain) is this:
Close your eyes and sit or lie in a relaxed position. On a scale of one to ten (one being not-so-bad, ten being worst-ever), rate the severity of your headache. Next, ask yourself the following questions, keeping your eyes closed and your position relaxed. Before going on to the next question, make sure you've fully answered the one before it:
Where is the headache? (Don't point; figure out in words exactly where the pain is.)
What size is it? (Again, don't use your hands to illustrate. Give it a size in inches or centimeters, or use an image, such as a tangerine.)
Describe its shape.
How far in does it go?
Describe its color. (Yes, it will have a color.)
Within three repetitions (usually less), the headache should be gone.
There are many other good pain visualizations (and many books in which you can find them, such as
Acupressure Headache Cure
Another good, and quick, way to relieve a headache without medication is to grasp the skin between the thumb and forefinger between those same two fingers on your other hand. If the headache is on the left side, grasp the right hand, and vice versa. Choose the part of the hand farther in, toward the wrist, and press hard for several seconds. It will help relax the muscles associated with the headache if you breathe slowly and deeply as you are pressing the “headache spot.” A third method is to press firmly just above the wrist, on the thumb side.
Because most of these medications affect serotonin, the “calming” brain chemical (which also has to do with regulating sleep cycles), fatigue is not an uncommon side effect. Usually, your system will get used to the medication within a few weeks, and this will no longer be a problem. In the meantime, you and your doctor might decide it's best for you to take your medication a few hours before bedtime so that you can benefit from any mild sedation by getting a good night's sleep.
You might also find it helpful to have a little coffee or cola during the day, but take care: Caffeine can significantly increase anxiety. Some teas and soy drinks contain low amounts of caffeine and might be preferable. Better still, some exercise during the day — ideally, a brisk walk, at the very least — should bring your energy level up naturally.
Keep a close eye on diet, as well: High-protein, low-fat choices such as eggs, fish, lean chicken breast, or small quantities of nuts can also help keep you more energetic throughout the day. Avoid starchy foods such as potatoes or white bread, as those carb-heavy choices can make you sleepy. You'll also want to avoid high-sugar treats, which will probably just make you feel revved up and possibly anxious at first, and then tired later.
Antidepressants, including many of the most popular, have been shown to increase suicidal thoughts and actions sometimes in teens and children. If you are seeking treatment for child or teen OCD or depression, get the facts. Talk with medical professionals and learn as much as you can before deciding on a medication. Make sure to provide appropriate follow-up and monitoring.
If your new medication is keeping you from getting a good night's sleep, you may simply be able to change the time of day at which you take it. Talk with your doctor. She may also be able to prescribe a temporary mild sleep aid that will not conflict with the OCD medicine.
Simple relaxation exercises or a calming bedtime routine might also help you to enjoy a full night's rest. General sleep advice includes choosing the same bedtime each night so that your body gets used to going to sleep then, and refraining from vigorous exercise (gentle stretches are okay, and may even be beneficial) or reading stimulating books right before bed.
Your bed, most insomnia experts advise, should be used only for sleeping or sex, so that you associate it with rest and tranquility. You might also try to turn off repetitive restless thoughts by replacing them with more benign ones. Thinking of, and perhaps even visualizing, a beautiful, peaceful place, whether real or imagined, in all its calming and restful detail, can often be sleep inducing. Some people find it helpful to play passive types of word games, such as “A, My Name Is Alice”: (“A, my name is Alice, and my husband's name is Art. We come from Arkansas and we sell apples. B, my name is Bonnie and my husband's name is Brad…”). These kinds of thoughts generally do not unduly tax or overstimulate the brain. If you find that they do, switch to something else.
One rather common side effect is increased dream activity. You may discover that your dreams take on a more vivid or active quality. You may also find that you have been more physically active while asleep than you are used to. This is harmless (although if it causes you distress, you might want to evaluate how well your medication is working for your OCD). However, some antidepressants, though not those primarily used to treat OCD, can cause a greater-than-average incidence of nightmares.
Another tactic often suggested is to avoid staying in bed for more than thirty minutes or so if you find that you can't fall asleep. Rather than toss and turn, it might be more helpful to get up and engage in a boring, repetitive task, such as cleaning out drawers or paying bills. Keep a mindless task or two at hand for those times when you just can't sleep; a short while at one of these, and your bed — and sleep — may become entirely appealing again!
Nausea or Vomiting
Nobody likes to feel queasy — or worse. Taking your medication with a little bit of food or at certain times of day might help offset this problem. Eating or drinking ginger-containing products may help, but read the label, and do not have more than 1000 mg (one gram) of ginger in a day. If the nausea persists, get in touch with your doctor without delay. You should be able to change the dosage or type of medication.
Certain medications seem more likely to cause one side effect than others. One might be more closely associated with appetite changes, for instance, and another with insomnia or fatigue. Although many of the newer drugs pose less risk of side effects than their older counterparts, not all medications work for all patients, which is why the older drugs are still used, as well. Discuss the side effect profile of any proposed medications with your doctor to address these specifics in terms of how they relate to you.
If you're having problems with vomiting or excessive diarrhea or nausea, talk with your doctor as soon as you can. Adding physical misery or poor nutrition to your problems will definitely not be therapeutic.
Drink plenty of liquids to replace the fluid your body has lost. Vitamin or sport drinks can be especially helpful. An over-the-counter preparation might be beneficial, as well. (However, some physicians might advise against this.) As in all cases, consult your doctor or pharmacist before taking any additional medicines. When you're ready to eat, start slowly and gently. Saltines, white rice, dry toast, and tea are soothing foods for a troubled stomach, and unlikely to overtax it. If the situation persists for longer than a day, or if you also have a fever, get medical advice quickly.
Your best bet for handling this may just be to employ common folk wisdom: drinking prune juice and eating high-fiber foods such as fruits and vegetables, popcorn, beans, and bran-containing whole grain-breads or muffins. Drink plenty of water. Over-the-counter preparations are not recommended for use over long periods of time.
Excessive Perspiration (Hyperhidrosis)
Obviously, hyper-perspiration is also not much fun. On the plus side, it is a less troubling side effect than some in that it is mostly just a nuisance (although, at its worst, it can be socially disabling).
If you tend toward low blood pressure, you might want to take extra care with tricyclics and other medicines known to affect blood pressure, particularly if you are older. Lowered blood pressure or diarrhea, if it has caused too much dehydration, can be responsible for dizziness. Some medications cause dizziness even without those other symptoms. One way to combat this is to stay well hydrated.
Beyond carrying a handkerchief, taking extra showers, and making sure not to neglect the use of a good antiperspirant or deodorant, there are limited choices for dealing with this problem. A dermatologist can prescribe a topical gel to help control it. Only you can know whether this side effect is bad enough to cause a re-evaluation of your meds, or whether it's worth putting up with when you consider the benefits.
Changes in Appetite
One thing you may notice once you begin your medication is an increased craving for sweets. This is not necessarily your imagination. Some medications do increase carbohydrate cravings. A very sensible way to combat this is to choose foods that give some illusion of sweetness without a lot of sugar and calories.
Low-fat yogurt, bananas, strawberries, sweet potatoes, oatmeal with low-fat milk and a handful of raisins, and cold cereal (choose a crispy rice or grain cereal with minimal sweetener) can help you to satisfy sweet-food cravings. Fruit “smoothies” — fresh fruit blended with skim or low-fat milk — can also help take the edge off. Many Web sites offer weight-loss (or maintenance) tips along with healthful and nutritious recipes. Don't neglect exercise, either. It can help reduce appetite and weight gain.
Sexual Side Effects
Like many other kinds of drugs, the medication you use to treat your OCD may present what are known as “sexual side effects”: delayed or non-existent orgasm or erection, decreased (or, less commonly, increased) interest in sex, and other concerns. There are several possible solutions.
First of all, you
Some patients find that they can “go off” their SSRIs on weekends so that they can at least enjoy sex during that time. Others find a change in medication or dosage works in their favor. Remember, these problems are not uncommon, and they are not impossible to solve.