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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Kimbersaur on September 24, 2008, at 0:44:03
I'm thinking of making a major change and was hoping for some advice/opinions. Here's my story:
I'm currently taking Lamictal (200mg) and Seroquel (50mg). I've was put on both of these drugs about five years ago (after trying several others) for what they said was bipolar disorder (the doses were higher back then). I was also on Effexor (150mg) for OCD. The Effexor almost completely erased my OCD for years, however after a year in a serious relationship I went off of it so that I could have orgasms (this was 3 years ago). The OCD was okay for a while, but then it started getting worse and worse and worse, and now 3 years later I feel like I need something for it again. Over the past year I've tried several different drugs for the OCD, however all the SSRIs and SNRIs gave me anorgasmia (which I can't tolerate or at least really don't want to have to) and Anafranil hit me like a ton of bricks with many side-effects, including anorgasmia. I just tried Abilify which helped a bit for the first two weeks, then suddenly made my intrusive thoughts worse than ever before. I know I didn't give the Abilify very long but the thoughts plus the other side effects were too much.
So here I am at square one again and I really want to take Cymbalta, which worked well for the OCD and had the least side effects. However, this time I am interested in trying Wellbutrin on top of it in order to help the sexual side effects, something I was always against because it sounded like "too much meds". Well, "too much meds" seems worth it at this point. The OCD itself is getting to be "too much".
So my question is, is Seroquel, Lamictal, Cymbalta and Wellbutrin a safe combination? Is it too much meds?
Thank you for your time,
Kim
Posted by greywolf on September 24, 2008, at 17:23:11
In reply to Thinking of making a huge med change, posted by Kimbersaur on September 24, 2008, at 0:44:03
I think, personally, the case for Wellbutrin helping with anorgasmia may be overstated. I have tried Cymbalta for both depression and OCD, but I didn't tolerate it well, and it had absolutely no effect on my OCD even at therapeutic levels.
Have you tried CBT for the OCD?
Greywolf
Posted by azalea on September 24, 2008, at 17:35:41
In reply to Thinking of making a huge med change, posted by Kimbersaur on September 24, 2008, at 0:44:03
Is the Seroquel 50mg helpful? At 50mg it only blocks histamine and will help you sleep but that's probably about all. 300mg is the recommended dose for bipolar depression. The Lamictal alone might be enough to treat bipolar depression.
Have you tried inositol supplements for OCD?
> I'm thinking of making a major change and was hoping for some advice/opinions. Here's my story:
>
> I'm currently taking Lamictal (200mg) and Seroquel (50mg). I've was put on both of these drugs about five years ago (after trying several others) for what they said was bipolar disorder (the doses were higher back then). I was also on Effexor (150mg) for OCD. The Effexor almost completely erased my OCD for years, however after a year in a serious relationship I went off of it so that I could have orgasms (this was 3 years ago). The OCD was okay for a while, but then it started getting worse and worse and worse, and now 3 years later I feel like I need something for it again. Over the past year I've tried several different drugs for the OCD, however all the SSRIs and SNRIs gave me anorgasmia (which I can't tolerate or at least really don't want to have to) and Anafranil hit me like a ton of bricks with many side-effects, including anorgasmia. I just tried Abilify which helped a bit for the first two weeks, then suddenly made my intrusive thoughts worse than ever before. I know I didn't give the Abilify very long but the thoughts plus the other side effects were too much.
>
> So here I am at square one again and I really want to take Cymbalta, which worked well for the OCD and had the least side effects. However, this time I am interested in trying Wellbutrin on top of it in order to help the sexual side effects, something I was always against because it sounded like "too much meds". Well, "too much meds" seems worth it at this point. The OCD itself is getting to be "too much".
>
> So my question is, is Seroquel, Lamictal, Cymbalta and Wellbutrin a safe combination? Is it too much meds?
>
> Thank you for your time,
>
> Kim
Posted by Kimbersaur on September 24, 2008, at 22:28:58
In reply to Re: Thinking of making a huge med change, posted by greywolf on September 24, 2008, at 17:23:11
> I think, personally, the case for Wellbutrin helping with anorgasmia may be overstated. I have tried Cymbalta for both depression and OCD, but I didn't tolerate it well, and it had absolutely no effect on my OCD even at therapeutic levels.
>
> Have you tried CBT for the OCD?
>
> GreywolfI already know that the Cymbalta works well for me, which is why I'm willing to try the Wellbutrin/Cymbalta route even though it seems like a lot med-wise.
I have been in therapy, but it wasn't CBT. I think I need to try CBT if I want to really make progress with my OCD on top of just meds, which I know won't "cure" me.
Thank you for your time!
Posted by Kimbersaur on September 24, 2008, at 22:32:35
In reply to Re: Thinking of making a huge med change » Kimbersaur, posted by azalea on September 24, 2008, at 17:35:41
> Is the Seroquel 50mg helpful? At 50mg it only blocks histamine and will help you sleep but that's probably about all. 300mg is the recommended dose for bipolar depression. The Lamictal alone might be enough to treat bipolar depression.
>
> Have you tried inositol supplements for OCD?I'm not sure how much the Seroquel does for me aside from sleep. I do know that when I don't take it I can't sleep and I get a bit more agitated. I used to be on 250mg, but when I tried to go down to as few meds as possible I wasn't able to take it lower than 50.
I am taking Inositol and it helps with the intrusive thoughts but not with the contamination issue.
Thank you for your time!
Posted by azalea on September 25, 2008, at 5:06:26
In reply to Re: Thinking of making a huge med change, posted by Kimbersaur on September 24, 2008, at 22:32:35
If insomnia is a problem, perhaps Ambien or Lunesta would be beneficial. Then you could discontinue the Seroquel which is more likely to cause next day sedation and other side effects.
The study using inositol had people taking 18g, which is a lot considering most supplements I've seen come in 500mg capsules.
> > Is the Seroquel 50mg helpful? At 50mg it only blocks histamine and will help you sleep but that's probably about all. 300mg is the recommended dose for bipolar depression. The Lamictal alone might be enough to treat bipolar depression.
> >
> > Have you tried inositol supplements for OCD?
>
> I'm not sure how much the Seroquel does for me aside from sleep. I do know that when I don't take it I can't sleep and I get a bit more agitated. I used to be on 250mg, but when I tried to go down to as few meds as possible I wasn't able to take it lower than 50.
>
> I am taking Inositol and it helps with the intrusive thoughts but not with the contamination issue.
>
> Thank you for your time!
>
Posted by Kimbersaur on September 25, 2008, at 16:11:38
In reply to Re: Thinking of making a huge med change, posted by azalea on September 25, 2008, at 5:06:26
> If insomnia is a problem, perhaps Ambien or Lunesta would be beneficial. Then you could discontinue the Seroquel which is more likely to cause next day sedation and other side effects.
>
> The study using inositol had people taking 18g, which is a lot considering most supplements I've seen come in 500mg capsules.I've been taking about 14 1/2 grams a day of inositol and it has helped a little.
Aren't sleeping pills more addicting than Seroquel? Is it safe to use them in the long-run?
Thanks again for your time!
Posted by azalea on September 25, 2008, at 17:14:38
In reply to Re: Thinking of making a huge med change » azalea, posted by Kimbersaur on September 25, 2008, at 16:11:38
Yes, sleeping medications like Ambien and Lunesta are more addicting than Seroquel, but the risk is generally presumed to be low. If you have a history of alcohol or benzodiazepine addiction, medications like Ambien and Lunesta are probably not a good choice. However, prolonged use of Seroquel (or any antipsychotic) carries the risk of tardive dyskinesia. The risk is lower than with typical antipsychotics like haldol, but it's still a risk.
If the anti-histamine properties of Seroquel help you sleep, perhaps a medication that purely blocks histamine would useful. Options include OTC Unisom tablets (doxylamine succinate), OTC Unisom liquigels (diphenhydramine hydrochloride). But these can cause next day sedation because of the long half life, which is why many patients prefer Ambien or Lunesta.
>
> Aren't sleeping pills more addicting than Seroquel? Is it safe to use them in the long-run?
>
> Thanks again for your time!
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