Posted by JohnL on February 16, 2000, at 4:26:55
In reply to some advice please, posted by brandon J on February 14, 2000, at 11:05:20
Brandon,
It's too bad your doc will not consider all the options to get you well. There are so many drugs available. I think it's a mistake to rule any out. In the old days we didn't have many choices. But today there are many.
The stimulants do seem to me to be the best option for you. In theory anyway. The OCD is usually serotonin related though. Off the top of my head, an SSRI + stimulant makes a lot of sense in your case. This is often a wonderful combination anyway for a variety of psychiatric conditions. Stimulants can also counter the sexual side effects of SSRIs, making the combination attractive from a variety of vantage points.
If your doc won't prescribe a stimulant, I would seriously consider calling around to find one who will. What your doc seems to brush off is that a person may indeed become addictive or abusive with one stimulant, but not with another. They aren't the same. Results or response on one does not predict results or response with another. Several people here have done fine for example with Adderall when they found Ritalin too addictive. A non-addictive stimulant that works well in adults is Cylert. It requires periodic blood testing to check liver function, but it would nullify your doc's argument of addiction. But I think you need a doc who is more concerned with getting you well. One who isn't afraid to use all available possibilites. It's a risk/benefit choice. In my opinion, in a worst case scenario, it's a better choice to be well, yet addicted, than not well and not addicted.
In summary, my opinions are:
Try Cylert + SSRI. Remind your doc Cylert is usually non-addictive. But you may actually need to try three different stimulants in short one/two week trials to find the one best for you.
And/or...call around for another doc who is not timid in getting you well. SSRI for the OCD, stimulant for the ADHD, possible antipsychotic to smooth it out and help with sleep. Just my opinion. I would be mightly disappointed if your doc was mine. I would have a phone in one hand and the yellow pages in the other.P.S. Stimulants increase NE/dopamine activity. Risperdal reduces dopamine activity...just the opposite of what you need. Stimulants + antipsychotics work very well together, but an antipsychotic alone for your symptoms doesn't make much sense to me. Again, I'm skeptical of your doc's whole approach with you. He must have what he feels are good reasons, but I can't figure out what they are.
poster:JohnL
thread:21449
URL: http://www.dr-bob.org/babble/20000209/msgs/21764.html