From my experience treating those with OCD, when SSRI medications are used, the person typically has one of 3 responses. Most people (85%) have good responses to Luvox/Lexapro/Zoloft/etc. The other 15% fall into two categories: those who have very little to no symptom response from the medication; and those who have a negative, counter-intuitive response where their OCD symptoms and general anxiety is made worse.

Upon testing, the folks in the last category typically have methylenetetrahydrofolate reductase (MTHFR). This is an inherited gene condition where the MTHFR enzyme does not work correctly. This causes problems with the body’s ability to process amino acids -the building blocks of many things, especially neurotransmitters. It can play a role in metabolism of medications as well, in this case SSRI’s. People with MTHFR often have had other examples throughout their lives of ‘odd reactions to various medications.’

If MTHFR is the reason the person cannot take an SSRI for their OCD, they can work with their prescriber to try clomipramine (Anafranil) since it is a heterocyclic and not an SSRI, or they can possibly try a prescribed supplement called Enlyte that can help the MTHFR issue.

As always, consult your medical or psychiatric provider about all of these factors before you take any action.

Thanks for reading! Live happy!