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Re: Sudden sensitivity to SSRIs/side effects? » Dispossessed

Posted by phidippus on March 4, 2014, at 1:31:02

In reply to Re: Sudden sensitivity to SSRIs/side effects?, posted by Dispossessed on March 3, 2014, at 21:05:35

Eric,

> Its pure OCD only. Basically, it is a fear that I lose control and either main/hurt myself or somebody else

These are my main obsessions as well and I have brought them under great control with Brintellix.

Have you done much exposure therapy for these thoughts? For instance have you tried to lose control or pretended to kill yourself?

A very effective method of handling these thoughts is to agree with them until they lose their power. Purposefully imagine yourself taking your life in a comical manner-for some reason, I find killing myself with a lawn mower to be totally hilarious.

>I have concerns with antipsychotics, given the akathisia risk and the fact that most of them hit a lot of receptors (contributing to their huge side effect profile).

In persons with OCD it is often found there is excessive output of dopamine in the nucleus accumbens. Sometimes an SSRI is not enough to treat OCD adequately, so APs are used to control the excess dopamine which may be an issue.

Just because APs have a huge side effect profile doesn't mean you're going to experience them. As for AP induced akathisia, it is much easier to treat than SSRI induced akathisia.

> I was also very careful to avoid anything that could potentially increase anxiety, like caffeine/alcohol

Studies have shown that both caffeine and alcohol have positive effects on OCD.

>Even though I was only taking 25mg, I experienced...

I wonder if some of the side effects you experience from medication are psychosomatic.

> > Perhaps Phiddipus can comment on combining Brintellix and nortriptyline.

I have never tried it.

> I would definitely be open to trying another tricyclic

Clomipramine is the only one studied in the treatment of OCD.

>How long should I have given these side effects to fade? Should I have given it 2-3 months?

With SSRIs I give it about 6 weeks before I give up because of side effects. And I am talking about a therapeutic dose-so for Zoloft it would have been 200-400 mg.

> Anyone got any reason why I'm sensitive to these side effects?

Take higher doses for longer periods of time and see what happens.

Eric


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