Posted by yxibow on December 26, 2006, at 1:26:14
In reply to ocd out of control, will ultram or a benzo help, posted by medievil on December 24, 2006, at 9:46:08
> my OCD is out of control, and i need some relief now! i was wondering about ultram and benzo's for ocd, or any other meds that kill off ocd right away, only temp untill parnate starts working thx!
>
> any experiences?If your doctor thinks an MAOI will work, I can't argue with him but its not the first thing on the list that I would go for certainly.
Second, what kind of OCD are we talking about, pure obsessions, pure compulsions, obsessions and compulsions, washing, hoarding, counting, trichotillomania, etc?
I would start off with Luvox personally, it does have more effectiveness than other forms of SSRIs probably partially because of its sedating nature. It has a wide range of dosing and though normally at 300 it can be dosed to 400 and possibly 450.
Beyond Luvox, Anafranil is still a gold standard, especially for tough obsessional thought cases.
Augmentation of clonazepam with any SSRI that is not sedating is probably a good thing -- clonazepam may be needed initially on its own regards before an SSRI or a TCA/SRI such as Anafranil starts to kick in.
If those are exhausted I might possibly look towards MAOIs but I would look to augment Luvox and possibly Anafranil (not sure how much its done there) with an antipsychotic, probably a low dose of Seroquel or Zyprexa -- Geodon and Abilify would probably be too activating due to akathisia but you might not be susceptible -- some people are more so. If you have tics, the old line drug Orap is sometimes used although cautiously.
I'm not quite sure why diving straight into an MAOI is being done for OCD unless there's more to the message and you've been through all of the above and then some. Its a serious type of medication and as noted above, opiates and all sorts of things can react with it, and having already OCD on board unless you're not obsessing about medications, which some do, I personally wouldn't go for an MAOI, but that, again, is up to you and your doctor since you've already stated the answer to your own question basically that you are going to take an MAOI. (And by the way, you have to wait 14 days to flush out any of the drugs I mentioned before an MAOI anyhow. It just seems overkill unless your YBOCS is 40, you have never responded to CBT (behavioural therapy), you have never been checked into a hospital where they can monitor CBT, etc. The severity of the problem hasn't really been mentioned, so its hard to respond other than sympathize.
And the trend towards the notion of opiates to "solve" psychiatric disorders is an old line ideology -- I don't know why it is even in discussion with OCD. I know its a painful disorder, I had a breakout of it all through puberty to high school where it was worst. But hospitalization and eventually an SSRI actually after I was mostly "well" was the course. But you can't "drown" the pain of OCD any more than drinking it away -- not to mention that these experiments on here with opiates just sound like a demand of a doctor for a morphine drip. Psychiatrists can lose their licenses over these things, but I've said my piece on it. Sure, I'd love it if oxycontin took away my anxiety disorder but I don't see that happening any more than a fistful of ibuprofen. Just my opinion anyhow.I hope you are having the best of a holiday season
-- tidings
Jay
poster:yxibow
thread:716104
URL: http://www.dr-bob.org/babble/20061224/msgs/716408.html