Which antidepressant is more likely to be effective for reducing obsessive-compulsive symptoms due to its mechanism?

The effectiveness of antidepressants in reducing obsessive-compulsive symptoms is closely linked to their specific mechanisms of action. Fluvoxamine and Paroxetine are both selective serotonin reuptake inhibitors (SSRIs), which are known to be effective in treating obsessive-compulsive disorder (OCD). Among the available choices, Fluvoxamine has a well-established efficacy in OCD due to its strong serotonergic effects, as it increases the levels of serotonin in the synaptic cleft, thereby contributing to improved mood and reduced anxiety, which are essential in managing OCD symptoms.

While Paroxetine is also an SSRI and has demonstrated efficacy in OCD, Fluvoxamine is more specifically indicated for this condition in clinical guidelines. Desipramine and Amitriptyline belong to the tricyclic antidepressant (TCA) category, which are generally not the first-line treatment for OCD. Their mechanisms primarily involve norepinephrine reuptake inhibition and other pathways that are less targeted towards the serotonergic system.

In summary, the likelihood of effectiveness in reducing obsessive-compulsive symptoms favors Fluvoxamine due to its targeted action on serotonin reuptake, making it preferable for this specific condition among the listed options.