When people think about treating a personality pattern like Obsessive-Compulsive Personality Disorder (OCPD), medication isn't usually the first thing that comes to mind — and a 2022 systematic review confirms why. The researchers searched for every randomised controlled trial testing medication for OCPD and found just two.
The first tested fluvoxamine (an SSRI) against a placebo in 24 people with OCPD and found it worked significantly better, with few people dropping out of treatment. The second compared two different SSRIs — citalopram and sertraline — in 71 people who had both OCPD and depression, and found citalopram edged out sertraline, again with fewer dropouts.
That's a reasonable starting signal, but the review's authors were careful to point out that two small trials isn't much to build firm conclusions on. They called for more, better-designed studies before medication can be confidently recommended as a primary treatment for OCPD.
What this means in practice: medication may have a role to play, particularly alongside other conditions like depression or anxiety, but it isn't a stand-in for therapy that addresses the thinking patterns and behaviours at the heart of OCPD. If you're weighing up your options, it's worth having that conversation with both a GP or psychiatrist and a psychologist, rather than either alone.