Background: Obsessive–compulsive disorder (OCD) often shows an incomplete response to selective serotonin reuptake inhibitors (SSRIs). Selenium, an antioxidant micronutrient, may improve treatment outcomes when used as an adjunct. Aims and Objectives: This study aims to evaluate the safety and efficacy of selenium add-on therapy with fluoxetine in patients with OCD. Materials and Methods: In this prospective, open-label, randomised controlled trial, 60 adults with diagnostic and statistical manual of mental disorders 5 diagnosed OCD were allocated in a 1:1 ratio to receive either selenium 200 μg/day plus fluoxetine 20 mg/day (Group A, n=30) or fluoxetine alone (Group B, n=30) for 6 weeks. Symptom severity was assessed using the Yale–brown obsessive compulsive scale (Y-BOCS). Hematological and biochemical parameters were monitored for safety. Statistical analysis was performed using independent and paired t-tests, with P<0.05 considered significant. Results: Baseline demographic and laboratory parameters were comparable between groups (mean age: 30.13±5.54 vs. 30.07±6.68 years; P=0.967). Group A demonstrated a significantly greater reduction in Y-BOCS scores compared to Group B, with a mean change of −4.40±1.45 versus a mean increase of 1.84±0.73 (P=0.001). Liver and renal function tests showed no significant intergroup differences in bilirubin (0.13±0.01 vs. 0.07±0.01 mg/dL; P=0.156), serum glutamic-oxaloacetic transaminase (1.80±1.12 vs. 1.90±1.53 U/L; P=0.781), serum glutamic pyruvic transaminase (2.46±1.63 vs. 2.26±1.55 U/L; P=0.630), and urea (−0.80±0.71 vs. −1.20±1.39 mg/dL; P=0.178). Creatinine showed a statistical difference (0.04±0.02 vs. −0.05±0.01 mg/dL; P=0.001), values remained within normal limits. No serious adverse events were reported. Conclusion: Selenium add-on therapy significantly improves OCD symptoms with good tolerability and minimal laboratory changes, supporting its role as a safe and effective adjunct to SSRI treatment.
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