P: all drugs have side effects, some more sever than others
E: nausea, headache and insomnia are common side effects of SSRIs. Although not severe, they are often are enough to make a patient stop taking a drug. tricyclic antidepressants tend to have more side effects than SSRIs so are only used when SSRIs are not effective.
L: these side effects, and the possibility of addiction, therefore limit the usefulness of drugs as treatments for OCD