Posted by phidippus on February 10, 2015, at 15:48:45
In reply to OCD Dont know where to go, posted by Bill82 on January 30, 2015, at 20:56:23
First off, first line treatment for OCD is not medication, but ERP (exposure and response prevention). Its not easy to do, but if done properly, can curb even the worse ideations.
Second line treatment of OCD is treatment with a serotogenic drug. OCD involves lowered levels of serotonin in certain areas of the brain. Because of the physiology of OCD, you can't really treat it with anything else-unless you're using anti-glutamatergic drugs or antipsychotics to augment treatment with an antidepressant.
You described the medications you were on and I'm noticing a couple of trends with the antidepressants you've taken. Most or all of them caused an imbalanced emotional state: Mirtazapine, Luvox, Zoloft, Lexapro, Brintellix. This could be an indication of bipolar disorder, in which case you will need treatment with a mood stabilizer before you treat the OCD with an antidepressant.
Once you've treated the OCD with an antidepressant and you don't have the response you want, you'll want to augment with an antipsychotic (never take an antipsychotic alone to treat OCD-it'll just make it worse). The reason you want to augment with an antipsychotic is because OCD involves high levels of dopamine in certain parts of the brain, most notably the nucleus accumbens. Together the antidepressant and the antipsychotic will work together to lessen symptoms.
If you still don't have enough response to the antidepressant and the antipsychotic, it is advised that you add a anti-glutamatergic agent like Riluzole, Keppra, Zonegran, Topemax or Lyrica.
When you take antidepressants, typically, how long are you on them before you stop them because of side effects?
I too have severe OCD and have been able to conquer it with the right mix of medications and therapy. Write me back if you have any questions.
Eric
poster:phidippus
thread:1075804
URL: http://www.dr-bob.org/babble/20150129/msgs/1076216.html