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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by incubusfan5 on December 14, 2008, at 13:33:27
I've had terrible OCD/hyperfocus as early as I can remember(6 years old). I was intensly afraid of pencil "lead"(Even though it's made of graphite) and would carry around a rag to constantly spit in.
Later I became very preoccupied if people would make fun of brand of clothes I wore, or if I didn't have enough outfits.
I've been through many other obsessions that have torn apart my life. Medications I've tried are:
Parnate(Terrible hypotension which made me so weak)
Paxil, Zoloft, Effoxor(Fat and sweaty, no benefit).
Topamax - Dopamax
Lamictal 150mg(just started)
Wellbutrin XL 150mg(Just started a week ago)
Valium - helps a bit, but not enough
Abilify - was getting really restless, so I discountined it.I'm pretty desperate for any kind of relief. Any suggestions?
Posted by Phillipa on December 14, 2008, at 13:45:39
In reply to What's left to try for OCD?, posted by incubusfan5 on December 14, 2008, at 13:33:27
Luvox now on the extended version by brand name and fluvoximine generic. Love Phillipa
Posted by Valero on December 14, 2008, at 15:27:35
In reply to What's left to try for OCD?, posted by incubusfan5 on December 14, 2008, at 13:33:27
Clomipramine chlorhydrate ( ANAFRANIL in Europe)
V.
Posted by incubusfan5 on December 14, 2008, at 18:17:23
In reply to Re: What's left to try for OCD?, posted by Valero on December 14, 2008, at 15:27:35
Problem with Anafranil is it'll make me gain weight like crazy, as Paxil and Zoloft made me gain 50lbs.
Ugh
Posted by yxibow on December 15, 2008, at 4:54:01
In reply to Re: What's left to try for OCD?, posted by incubusfan5 on December 14, 2008, at 18:17:23
> Problem with Anafranil is it'll make me gain weight like crazy, as Paxil and Zoloft made me gain 50lbs.
>
> UghPaxil is much more notorious for weight gain than Anafranil. I don't recall if I ever gained that much but I took it years ago when my metabolism was different younger.
It's an individual thing as for weight gain, yes, the antihistamine effect of TCAs can make -some- people eat more but that's a fair part of the weight gain issue, I switched over from Luvox to Anafranil myself, only at about 75mg. Jumping to 100mg was a bit too much at the moment.Its actually probably doing moderately better for my depression than OC ruminating thoughts, as far as comparing to Luvox, but its too early to say what is going on.
Its not the "cleanest" agent but I think its worth a trial if you have been through other agents before.
It can also be supplemented with Seroquel, which, yes, is a weight gainer if you don't watch your eating habits and are sedentary -- I'm dealing with that but that's another story, but for OCD augmentation it would be probably a smaller dose, like 100mg or so.
I'm surprised that you're doing okay with Wellbutrin since it caused my OCD in the past to skyrocket, but everyone's different, maybe a stimulating agent is more calming.I would say my opinion of Anafranil is that it is a bit more noticeably stimulating than Luvox since it touches other transmitters.
Xanax might be better PRN than Valium, it has a quicker uptake. But not for extended periods because it probably can become more habituating than longer acting agents.
Finally, of course there is CBT, but you have to be receptive to it and it sounds like you still need to have some anxiety managed before you can work through things psychologically, which, for a number of types of OCD can be as effective as medication, or better, combined.
OCD does affect most people who have it for life as it is most often a genetic tendency triggered by some psychological or biological event that causes it to come out, but that doesn't mean that you can't get it under control and use CBT tools to manage it if you have other flareups in your life.
My case at the moment is a rather complicated but it does involve some OC components.
I assume you also know about the OC Foundation
www.ocfoundation.org
-- tidings
Jay
Posted by psychobot5000 on December 16, 2008, at 22:52:04
In reply to Re: What's left to try for OCD?, posted by incubusfan5 on December 14, 2008, at 18:17:23
> Problem with Anafranil is it'll make me gain weight like crazy, as Paxil and Zoloft made me gain 50lbs.
>
> UghJust to piggy-back on what others have said, as I understand it, a fair amound of theory and some evidence (and past clinical practice in the 1980s) suggest Clomipramine/Anafranil as being (by a small degree) the most effective anti-OCD medication available. I've never taken it, but it used to be considered the 'gold-standard' before SSRIs became automatically the first treatment for, like, everything.
From my own personal experience, I would also suggest Mirtazipine/Remeron. As far as I know, it's not widely used for OCD, but I have read that in 'anecdotal' cases it was extremely effective. I am one such anecdote. I have OCD comorbid with my depression. Most antidepressants help my OCD to a moderate degree, but Mirtazipine was much more effective for me--It worked fabulously--hardly had to worry about my OCD symptoms at all when I was on it. The drawback was side-effects. Weight-gain and sedation for some people.
Since Clomipramine is better-established for OCD anyway...
Anyway, best of luck to you.
Posted by psychobot5000 on December 16, 2008, at 22:54:07
In reply to Re: What's left to try for OCD? » incubusfan5, posted by psychobot5000 on December 16, 2008, at 22:52:04
Sorry to double-post, but just wanted to mention that I've had modest benefits from Cognitive Behavioral Therapy, in addition to medication. It's not a silver bullet, of course, but I found it worth the time.
This is the end of the thread.
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