Posted by yxibow on June 17, 2008, at 5:06:12
In reply to For OCD sufferers what meds have helped you., posted by BRC on June 16, 2008, at 18:23:43
> Hi,
>
> I haven't posted here in a long time. So, first I would like to tell everyone hello.
>
> I have really bad OCD. I have tried all the meds, but nothing really has helped.
>
> The reason I am asking is my long time p-doc is retiring this month and I will be seeing a new p-doc on my next visit.
>
> I have been on my regimine of meds for so long that I am afraid to mess with them, but the OCD isn't getting any better and I figure maybe a new doc will have a better alternative.
>
> I currently take cymbalta 60mg, Luvox 200mg, Klonopin 4mg, Remeron 30mg, Lyrica 300mg. All of the meds are not just for OCD. Some are for anxiety, depression, etc. And the meds work well for those ailments. That is why I am so hesitant to speak out about a change.
>
> It is just the OCD that is so bad. Especially the intrusive thoughts.
>
> I was just posting to get other's input on the situation.
>
> Thanks,
>
> BRCWhat form of OCD is it specifically -- is it only intrusive thoughts, or are there other aspects of it? Intrusive thoughts usually mean the repetitive unwanted thoughts of a specific thing over ad nauseum.
I currently suffer from an unknown amount of OCD, panic/anxiety, symptomatic forms of somatiform disorder and depression.
I can certainly understand unwanted OCD as I was in hospital younger for washing for reasons I won't go into for my privacy but my Y-BOCS was something like 36-39.
At any rate, that is a lot of serotonergic agents going on there so your psychiatrist, hopefully psychopharmacologist has to maneuver things around very carefully to prevent serotonin syndrome.
I can't tell you what will be most effective for you -- if you are someone with OCD who responds negatively to NE (norepinephrine) which raises adrenaline then in the long run Cymbalta may not be the best thing (even though theoretically the serotonin is 6:1 NE)
But I reread that about anxiety and depression.I think a new doctor, if not for anything else but medicine consultation is a good thing. But don't go in expecting a miraculous list of undiscovered drugs -- I got a second opinion, again for privacy I won't go into it -- the point was positive, but I was expecting that someone, someone out there, including this community had a disorder like my own.
So take second opinions with the knowledge that another doctor may have used different medications in his/her practice and may have a different strategy, but there are only so many medications out there and some which they may try to list, may interact with whatever you have been doing or trying.
If you didn't have so many serotonergic agents (Cymbalta, Remeron at the cusp of serotonin level, and Luvox) I would suggest consolidating all the serotonergic agents into a much higher dosage of Luvox, typically it can be dosed to 400-450mg, depending on the metabolism of the patient. Electric shocks may be a side effect, at least I had them, when exercising, just because of the level of agent. But that's an individual case.I think Luvox is actually an excellent agent for OCD as it was coined for, marketing, or reality -- it is more sedating than Prozac, which may hyperactuate things, although it was among the first used for OCD, and it doesn't suffer from missed dosage problems of the other sedating medication, Paxil.
There are also CBT methods -- and I know it is -Extremely- hard with intrusive thoughts, but there are some, for battling OCD. It is a lifelong biochemical condition triggered at some age, typically first onset around puberty to teenage, but could be earlier or later due to some psychological reason.But there is hope. Much research that I am intimately aware of (scanning) has been done since I had my first episode and I did attend a treatment program at a certain institution that helped follow up things.
Now, I'm battling something I've never seen before and agents have to be moved around very carefully, but I still understand intrusive thoughts, because I have random "full head" depending how anxious I am, which is basically still the OCD running along making random words and things I see or hear or have thought about in the past or just don't make particular sense.
Focusing on them of course makes it worse, yet letting it stream by and say "who cares" also is distracting from what I need to do because it still comes to the forefront.
So to sum up a long note -- its not all medication, its an art and a science, and some of it may be rehabilitation work and CBT and some people with OCD tend to work better with structure, not straying away from things, which I admit I do -- like typing here now :) Okay, I had to put some humour into what I know is a really bad situation (for all of us here, I'm sure we can relate on some level).
-- best wishesJay
poster:yxibow
thread:834957
URL: http://www.dr-bob.org/babble/20080617/msgs/835024.html