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The mechanism of action of the drugs effective in treating OCD clomipramine, a non-selective serotonin reuptake inhibitor, and the selective serotonin reuptake inhibitors SSRIs: citalopram, fluoxetine, fluvoxamine, sertraline and paroxetine has given rise to the hypothesis that deficient serotonin function is a key element in the pathophysiology of OCD. These drugs block serotonin reuptake by the pre-synaptic neuron, thereby increasing serotonin availability at post-synaptic receptors. Pharmacological Treatments. Direct, controlled comparison studies have found fluvoxamine, paroxetine and sertraline equal in efficacy to clomipramine, the first drug that was demonstrated to be effective in treating OCD.

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