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Dr. Bob is Robert Hsiung, MD,
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Posted by OldSchool on January 24, 2002, at 14:59:41
In reply to what med is best for ocd?, posted by Tammy on January 24, 2002, at 14:39:31
> anybody have a good experience with ocd meds?
> with the meds for ocd, what r they trying to zero in on? like paxil inhibits the re-uptake of seritonin
> wellbutrin does the dopamine and norepeniphren and re-uptake
> thanks for your input.....In the USA the two main meds used for OCD includes the SSRI Luvox and the tricyclic antidepressant Anafranil. Both of these are potently serotonergic. OCD medications generally target serotonin. Although Luvox is the flagship SSRI for OCD, all of the SSRIs can be used for this. Prozac, Paxil and Zoloft are used for OCD.
Antidepressants which do not increase serotonin very much such as the older tricyclics, are not very effective in combatting OCD.
Posted by Dinah on January 24, 2002, at 16:04:41
In reply to what med is best for ocd?, posted by Tammy on January 24, 2002, at 14:39:31
I found that Luvox was extremely effective in controlling my OCD. It did have a flattening effect on my emotions and caused some cognitive dulling, though, which caused me to go off it. I always suspected that it worked by making my memory so bad that I couldn't remember what to obsess about. But I was on it for 4 years and had no other side effects. And if the OCD ever becomes unmanageable, I will gladly go on it again.
Posted by Krazy Kat on January 24, 2002, at 16:19:50
In reply to what med is best for ocd?, posted by Tammy on January 24, 2002, at 14:39:31
Maybe I'm not a "pure OCDer", but both Topamax and Depakote helped me with my OCD. I look at the OCD as part of my thought disorder, rather than my mood disorder (manic depression). I'm not sure why stabilizers help, but they have - when I went off Depakote, it came back full swing plus.
Good luck.
- KK
Posted by OldSchool on January 24, 2002, at 17:29:17
In reply to Re: what med is best for ocd? » Tammy, posted by Krazy Kat on January 24, 2002, at 16:19:50
> Maybe I'm not a "pure OCDer", but both Topamax and Depakote helped me with my OCD. I look at the OCD as part of my thought disorder, rather than my mood disorder (manic depression). I'm not sure why stabilizers help, but they have - when I went off Depakote, it came back full swing plus.
>
> Good luck.
>
> - KKActually, OCD is not classified as a "thought" disorder. A thought disorder is more along the lines of psychotic disorders, ie; schizophrenia. Distorted perception is a thought disorder. OCD is officially classed as an anxiety disorder, along with panic attacks, GAD and PTSD. The whole point of OCD is that you have these repetitive thoughts over and over again which become "stuck" but you always recognize the thoughts are not true. Thats what creates the anxiety.
Old School
Posted by Tammy on January 24, 2002, at 21:13:31
In reply to Re: what med is best for ocd?, posted by OldSchool on January 24, 2002, at 17:29:17
old school,
are u still taking meds for ocd? did u have therapy does it help?
Tammy:)
Posted by finelinebob on January 24, 2002, at 21:33:02
In reply to Re: what med is best for ocd?, posted by OldSchool on January 24, 2002, at 17:29:17
Only good thing zoloft ever did for me on a long term basis was eliminate my ocd-like, anxiety-driven behaviors. So here's one confirming opinion on SSRIs having some effect there.
flb
Posted by Tammy on January 24, 2002, at 21:56:33
In reply to Re: what med is best for ocd?, posted by finelinebob on January 24, 2002, at 21:33:02
flb
are u still on meds..... are u'r fears resolved from the meds??? did u do therapy?
the reason i ask is because i fear just about everything. !!!!!!!!! and i feel i could never be happy........ and i have NOTHING to be unhappy about...... just negative thoughts constantly...
but somethings (thoughts) stay with me and i cant shake them...... i try my hardest...... !!!!!
and boy!!!!! old school, did u hit it right on the head with u'r last post.....
its true the thought causes u'r anxiety
thanks for the input.....
Posted by OldSchool on January 24, 2002, at 21:58:07
In reply to Re: what med is best for ocd? old school, posted by Tammy on January 24, 2002, at 21:13:31
> old school,
> are u still taking meds for ocd? did u have therapy does it help?
> Tammy:)I dont take meds primarily for OCD, I take meds for severe depression. I have had some OCD however and I find my OCD is more related to my depression. When my depression gets bad, my OCD flares up sometimes. I find that antidepressants clear up whatever OCD I have pretty good.
Never did therapy before so I cant comment. I prefer meds however I have read some things about Cognitive Behavioral Therapy being good for OCD, although medication is essential if the OCD is halfway bad.
Old School
Posted by OldSchool on January 24, 2002, at 22:02:18
In reply to Re: what med is best for ocd? flb old school, posted by Tammy on January 24, 2002, at 21:56:33
> flb
> are u still on meds..... are u'r fears resolved from the meds??? did u do therapy?
> the reason i ask is because i fear just about everything. !!!!!!!!! and i feel i could never be happy........ and i have NOTHING to be unhappy about...... just negative thoughts constantly...
> but somethings (thoughts) stay with me and i cant shake them...... i try my hardest...... !!!!!
> and boy!!!!! old school, did u hit it right on the head with u'r last post.....
> its true the thought causes u'r anxiety
> thanks for the input.....OCD is not my main problem Tammy, however my sister had BAD OCD in college. She never had any real depression like I have, much less a major depressive episode. My sis was on Luvox for about a year and a half and it worked really good for her and she is fine now, unlike me.
Try Luvox for OCD. Its a great drug for that.
Old School
Posted by Kat26 on January 24, 2002, at 22:39:46
In reply to Re: what med is best for ocd? flb old school, posted by Tammy on January 24, 2002, at 21:56:33
Tammy,
wow can I relate to that fear of "never being happy". I have been there. For years. I had severe OCD symptoms, and whenever something new came up, I was afraid that that particular thought would stay with me and torment me "for the rest of my life". I was afraid of meds for a long time.
I am also taking an SSRI, I am on Prozac now and have been for a year. For me it worked wonderfully. Like, "wow!" kind of wonderfully. aybe vbecause I really believed that it just had to work, because I had read a book about somebody for whom it worked and I wanted to be like that person?
I also did a short term cognitive-behavioral therapy, but only for a couple weeks.HANG IN THERE even if you think you will never be happy... oh don't believe that!!!
Kat26
Posted by petters on January 25, 2002, at 1:18:22
In reply to what med is best for ocd?, posted by Tammy on January 24, 2002, at 14:39:31
> anybody have a good experience with ocd meds?
> with the meds for ocd, what r they trying to zero in on? like paxil inhibits the re-uptake of seritonin
> wellbutrin does the dopamine and norepeniphren and re-uptake
> thanks for your input.....Hi...
Any ssri will help the OCD. Effexor in high dosages also make a good job for OCD. If ssri is not sufficient you can add buspirone ( Buspar) often with great result.
I have seen this regime in refractary OCD with very good result. For exampel one treathmentresistent patient with OCD respond very well when 80 mg Buspar was add to 60 Citalopram (Celexa)
Case raport with bromcriptin (Pravidel) to ssri have also been positive in some cases.
Best Wishes...//Petters
Posted by bob on January 25, 2002, at 1:23:07
In reply to Re: what med is best for ocd? flb old school, posted by OldSchool on January 24, 2002, at 22:02:18
Yes... I've taken all of the SSRIs, and for me, Luvox is the most efficacious for eradicating obsession. All of them are pretty good for it in the long run, though.
Old School:
You mentioned your sister took Luvox for awhile in college, and got better. Did she stop taking it and is now medecine free?
Bob
Posted by jimmygold70 on January 25, 2002, at 1:55:14
In reply to what med is best for ocd?, posted by Tammy on January 24, 2002, at 14:39:31
The best combination for OCD is high dose SSRI (Paxil/Prozac/Celexa 80mg,Zoloft/Luvox 200mg / day) + A low dose atypical antipsychotic (Risperdal 2-4mg/day, Zyprexa 5-10mg/day)
Jimmy
Posted by finelinebob on January 25, 2002, at 2:59:33
In reply to Re: what med is best for ocd? flb old school, posted by Tammy on January 24, 2002, at 21:56:33
> flb
> are u still on meds..... are u'r fears resolved from the meds??? did u do therapy?
> the reason i ask is because i fear just about everything. !!!!!!!!! and i feel i could never be happy........ and i have NOTHING to be unhappy about...... just negative thoughts constantly...
> but somethings (thoughts) stay with me and i cant shake them...... i try my hardest...... !!!!!Tammy,
Like Old School, my anxiety is driven more by my depression than the other way around. I'm on three meds right now -- nortriptyline, ritalin, and klonopin. Nortrip does the best for me in dealing with my depression, but does nothing for my anxiety as zoloft would. Then again, first time I was on zoloft I had a manic response to it, then the next two times it just made me fat (gained 50 pounds, cholesterol sky-rocketed ... my PCP pretty much "banned" me from taking it ever again ;^). Ritalin's there to augment the nortrip, and klonopin for anxiety.
After a few years on this cocktail, I've finally been able to make enough progress with my therapist to be able to see clearly that the status-quo just wasn't cutting it.
Prior to Sept11, my meds were managing my anxiety well enough for me to recognize it when it was flaring up and do what I needed to cope. In November, it all finally sunk in (being two blocks from the WTC when it happened, losing my job given conditions, etc.) ... like you, I was scared of everything. Or, perhaps, I was scared of nothing in particular ... just scared all the time.
Two things got me through ... a damn good therapist and acupuncture (which I've been blathering on about all over this board recently ;^). So now I'm getting back to where I was Sept 10th or so ... which is good because I just got a contract for designing a web site and that means I'll have to leave my apartment on a regular, daily basis!
I guess it gets down to how "diagnoses" and other such labels may help doctors talk to one another -- and I don't see how health insurance could exist without slapping a label on our foreheads -- but there's no clear line between anxiety and depression. I mean, when I talk about having "ocd-like behaviors", it's because I recognize their compulsive nature and how my other "anxiety indicators" ... heart rate, breathing, "buzz" along my nerves ... coincide with them. But the biggest effect of these behaviors is that they're my own way of "cutting", of self-injury -- but its a pain that I can control and that distracts me from pains I can't control. So, should I be taking meds for depression or anxiety to control this behavior?
You got me. Zoloft eliminated it, but it caused more problems than it solved for me. Nortrip and klonopin don't even touch it ... but they take care of enough in other departments so that I have the cognitive and emotional wherewithal to modify my behavior once I recognize it.
Well, okay ... IF I actually WANT to modify my behavior ....
pardon the ramble....
flb
Posted by Blue Cheer 1 on January 25, 2002, at 6:43:24
In reply to what med is best for ocd?, posted by Tammy on January 24, 2002, at 14:39:31
> anybody have a good experience with ocd meds?
> with the meds for ocd, what r they trying to zero in on? like paxil inhibits the re-uptake of seritonin
> wellbutrin does the dopamine and norepeniphren and re-uptake
> thanks for your input.....There is no "best" medication for OCD. All of the SSRIs have demonstrated efficacy; it's a matter of individual response, side effects, and patient preference. Clomipramine (Anfranil) helps many, too, but it's a tricyclic with some harsh side-effects.
SSRIs or combination pharmacotherapy *and* CBT is optimal treatment.
Blue
Posted by Dinah on January 25, 2002, at 8:49:53
In reply to Re: what med is best for ocd?, posted by Blue Cheer 1 on January 25, 2002, at 6:43:24
>
> SSRIs or combination pharmacotherapy *and* CBT is optimal treatment.
>
> BlueI have to agree with Blue here. We're not stressing the importance of CBT. The use of CBT techniques in reducing compulsive behaviors is extremely well documented. And even those who lean more towards the obsessive than the compulsive side (like me) can get a lot of benefit from CBT techniques. With the help of Klonopin and after four years on Luvox I found that my OCD was under control enough to stop the Luvox and I give all the credit to CBT. Some of the techniques are sort of silly but they work. But my best technique is my own CBT variant. I have externalized my OCD, given "her" a name, and when "she" acts up I don't take it personally. I just say "Now there sweetie, you're worrying about something that isn't real again" and then just repeat that to the thoughts as they recur. It's silly and it doesn't work 100% (unfortunately my OCD has control of my adrenal gland), but along with Klonopin it works pretty well. Of course, my OCD was on the moderate side and those with more severe cases might not be able to go without an SSRI.
Just my own experience, but also try S-T-O-P Obsessing and Brain Lock books. They're both pretty good.
Dinah
Posted by OldSchool on January 25, 2002, at 11:36:11
In reply to Re: what med is best for ocd? flb old school » OldSchool, posted by bob on January 25, 2002, at 1:23:07
> Yes... I've taken all of the SSRIs, and for me, Luvox is the most efficacious for eradicating obsession. All of them are pretty good for it in the long run, though.
>
> Old School:
>
> You mentioned your sister took Luvox for awhile in college, and got better. Did she stop taking it and is now medecine free?yeah it was a long time ago. She took Luvox for about a year and a half and was in intensive therapy too. She got totally well and is now doing great. Off meds for years. She never had any depression though, just OCD, panic...anxiety type probs. Graduated from college, she is doing quite well.
Eric
Posted by OldSchool on January 25, 2002, at 11:40:54
In reply to Re: what med is best for ocd? » Tammy, posted by jimmygold70 on January 25, 2002, at 1:55:14
> The best combination for OCD is high dose SSRI (Paxil/Prozac/Celexa 80mg,Zoloft/Luvox 200mg / day) + A low dose atypical antipsychotic (Risperdal 2-4mg/day, Zyprexa 5-10mg/day)
>
> JimmyI dont agree with this. Atypical anti-psychotics are rarely needed for OCD particularly in the mediumish dosages you recommend. Atypicals decrease serotonin levels which is generally bad for OCD. I have read of atypicals being used in severe, REFRACTORY cases of OCD. But for general OCD SSRIs or Anafranil should be sufficient.
I have also read of Risperdal actually inducing OCD, due to its serotonin decreasing properties.
Also, OCD is not considered to be very responsive to ECT.
Eric
Posted by Kat26 on January 25, 2002, at 14:35:03
In reply to Re: what med is best for ocd?, posted by OldSchool on January 25, 2002, at 11:40:54
I have worked with the book Brain Lock. I found it very helpful.
Kat26
Posted by bob on January 25, 2002, at 14:37:00
In reply to Re: what med is best for ocd? flb old school, posted by OldSchool on January 25, 2002, at 11:36:11
That is great news about your sister. I hear so few stories about people getting the help they need from these meds, and then eventually leaving them behind. Good for her.
For too many people, it seems meds are a life long sentence.
Posted by Krazy Kat on January 26, 2002, at 1:16:29
In reply to Re: what med is best for ocd?, posted by OldSchool on January 24, 2002, at 17:29:17
Old School:
I appreciate your commentary. But I must ask... why do you feel the need to antagonize everyone? Please post legitimate links to support your statements...
-- KK
Posted by Krazy Kat on January 26, 2002, at 1:20:10
In reply to Re: what med is best for ocd? old school, posted by OldSchool on January 24, 2002, at 21:58:07
"I have had some OCD however and I find my OCD is more related to my depression"
so, why are you even commenting on this? I'm sorry, but it seems this is not your expertise, so just leave it to others...
Posted by OldSchool on January 26, 2002, at 10:04:51
In reply to Re: what med is best for ocd? » OldSchool, posted by Krazy Kat on January 26, 2002, at 1:16:29
> Old School:
>
> I appreciate your commentary. But I must ask... why do you feel the need to antagonize everyone? Please post legitimate links to support your statements...
>
> -- KK
Antagonize people? I didnt realize I was doing that. Im just a well read person who has taken most of these drugs. Ive been told I have OCD before. Ive taken Luvox before. It is basic knowledge that medications used to control OCD are mostly serotonergic antidepressants such as the SSRIs and Anafranil. Look it up for yourself. Its not hard to find out. This isnt rocket science.Basic rule of OCD > > > > > > > > >serotonergic antidepressants are the place to start. Ask your own psychiatrist and I guarantee they will tell you the same thing I just told you.
Old School
Posted by Krazy Kat on January 27, 2002, at 15:44:27
In reply to Re: what med is best for ocd?, posted by OldSchool on January 26, 2002, at 10:04:51
Sorry, I've been going through a manic phase again. My comments were completely unnecessary.
However, "This isnt rocket science" is awfully degrading imho.
- KK
Posted by MB on January 28, 2002, at 15:38:20
In reply to Re: what med is best for ocd? » OldSchool, posted by Krazy Kat on January 27, 2002, at 15:44:27
I asked my doc about using this one as an antidepressant/andtiobsessive, but I haven't heard back yet. It sounds good because I've been having horrible akathisia and anorgasmia on Prozac, and Serzone isn't supposed to cause as bad dopamine depletion (akathisia) and anorgasmia!
Question is: does it work for OCD type problems?MB
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