Medication is rarely the first consideration when treating a personality pattern such as Obsessive-Compulsive Personality Disorder, and a 2022 systematic review explains why. The researchers searched for every randomised controlled trial testing medication for OCPD. They found two.
The first compared fluvoxamine, an SSRI, against a placebo in 24 people with OCPD. It worked significantly better, with few participants dropping out. The second compared two SSRIs, citalopram and sertraline, in 71 people who had both OCPD and depression. Citalopram edged out sertraline, again with fewer dropouts.
That is a reasonable starting signal and not much more. The review's authors were careful to point out that two small trials provide a thin base for firm conclusions, and they called for larger, better-designed studies before medication could be confidently recommended as a primary treatment.
In practice, medication may have a role, particularly where depression or anxiety are also present. It does not substitute for therapy addressing the thinking patterns and behaviours at the centre of OCPD. If you are weighing up your options, that conversation is best had with both a GP or psychiatrist and a psychologist rather than either alone.