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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 g_g_g_unit on March 4, 2012, at 2:20:37
So, Parnate has been playing havoc with my OCD and I was wondering if anyone could offer any insight. It would probably help if you're familiar with the inner workings of obsessive-compulsive disorder.
Basically, I used to have a (minor) problem with alcohol (ab)use. When my OCD first flared up in my very early 20s, I would drink to excess in order to escape. This was only on certain occasions - i.e. parties on the weekend - and I was otherwise able to remain completely sober and attend college during the week. My behavior has always been somewhat all-or-nothing in that respect.
Anyway, I grew tired of the hangovers, acting out when drunk, etc. and developed greater self-control. I would still drink, though more occasionally (once every 1-2 months) and could limit myself to remaining comfortably drunk (5-6 drinks over the course of a night).
I've stopped drinking completely since becoming depressed, as I attend far less social events. However, I went to my cousin's wedding last weekend and found myself having approx. four glasses of white wine and two glasses of vodka. I don't feel I would've continued past that point, but it's difficult to say because my family was leaving and I was forced to accompany them.
I've been terrified ever since that I might start drinking at some social occasion in the future while on Parnate, be completely unable to control myself and end up dying.
My understanding is that there's no direct danger posed by alcohol (other than tap beer, and arguably red wine), but for some reason, my OCD is playing up on this fear .. e.g. I believe I might black out and eat the wrong food and die.
I mean, it seems most logical to just think I'll give up drinking. But at the same time, that feels like reassurance/obsessive avoidance, because there's no rationale to believe I will drink to the point of blacking out or losing control and dying (I felt drunk but mostly in control at the wedding). And then I think "what if I can't stick to a commitment to not drink and end up dying, etc.?"
It's just hard for me to know what's reasonable caution, what's obsessive, etc. I feel like I want to 'confess', be told that I have a 'substance problem' and be 'punished', even though I know that isn't really true.
I should add that I'm only taking 15mg (10mg at 8am + 5mg at noon) of Parnate. I've begun to see some benefits - I get a calming stimulant effect after each dose, and notice an improvement in concentration and alertness.
There are some downsides - I'm not sleeping well, and I feel a little worn out (my body aches for some reason).
So I'm not sure what to do .. these concerns become worst at night when the stimulant effect's worn off and I feel depressed. My logic is that if it does help my anxiety and OCD, these concerns might not seem as big a deal. But it's been really hard not to just give up the trial, which I'm worried I might regret given that there isn't much left for me to try, and I really don't wanna go back on SSRIs.
I haven't spoken to my OCD therapist yet - I see her next Wed. I told my psychiatrist and he wasn't concerned because he felt there was a difference between drinking and binge drinking (which he termed a consciously enacted self-destructive behavior, which wouldn't just occur without my awareness).
Posted by SLS on March 4, 2012, at 6:49:30
In reply to Parnate and OCD problems, posted by g_g_g_unit on March 4, 2012, at 2:20:37
I imagine you know that Nardil is the MAOI with the best track record for treating OCD. I just thought I would mention it.
- Scott
Posted by SLS on March 4, 2012, at 6:55:11
In reply to Parnate and OCD problems, posted by g_g_g_unit on March 4, 2012, at 2:20:37
I don't know the inner workings of OCD. Sorry.
It occurred to me that using clonidine, or perhaps guanfacine, would mitigate the amphetamine-like effect of Parnate and exert an ant-OCD effect.
- Scott
Posted by Phillipa on March 4, 2012, at 9:58:15
In reply to Re: Parnate and OCD problems » g_g_g_unit, posted by SLS on March 4, 2012, at 6:55:11
Scott I am mostly sure you know OCD is considered an anxiety disorder. I relate to the post but only in the fatalistic thinking pattern. I don't think a stimulant is good in anxiety disorders maybe something like caffeine in tea or coffee. But nardil sounds like a better choice.
What happens on SSRI's with your ggg unit your OCD? I tend to agree that if a med works you will not obsess as much. Sounds like the O is more like what you have. Same here. Phillipa
Posted by emmanuel98 on March 4, 2012, at 17:48:35
In reply to Parnate and OCD problems, posted by g_g_g_unit on March 4, 2012, at 2:20:37
I know nothing about OCD, but if it helps -- I wouldn't worry so much about food interactions. It takes a few of ounces of cheese, for example, before it's a potential problem and most people won't eat more than an ounce or two at a sitting. Also, if you've never blacked out before, you're probably not going to start now. I drank heavily and am now in AA but only blacked out once in years and years of drinking. Some people I know blacked out everytime they drank. So stay away from the booze, but if you do drink, I don't think you have to worry so much about eating forbidden foods in a blackout.
Posted by g_g_g_unit on March 5, 2012, at 1:23:11
In reply to Re: Parnate and OCD problems, posted by emmanuel98 on March 4, 2012, at 17:48:35
> I know nothing about OCD, but if it helps -- I wouldn't worry so much about food interactions. It takes a few of ounces of cheese, for example, before it's a potential problem and most people won't eat more than an ounce or two at a sitting. Also, if you've never blacked out before, you're probably not going to start now. I drank heavily and am now in AA but only blacked out once in years and years of drinking. Some people I know blacked out everytime they drank. So stay away from the booze, but if you do drink, I don't think you have to worry so much about eating forbidden foods in a blackout.
Typically, if involves an intrusive thought, usually in the form of a question/postulation, which ultimately reflects on the sufferer's character. The catastrophes predicted by OCD are often highly unlikely (read: irrational), yet the sufferer is afflicted with a sense of responsibility in preventing them.
So, in my case, I keep thinking "What if I drunk *so* much while on Parnate that I black out and eat the wrong food, or haggle someone for drugs and snort coke and die?"
Yes, I have blacked out while drinking but that was very early on, in my early 20s, and, even while drunk, I haven't approached blacking out in 4+ years, which makes it irrational. And yes, I've mixed alcohol with drugs, but I don't believe I would be so senseless to on Parnate because I'm aware of how dangerous it is.
But I just experience that "What if ... you cause yourself to die" thought/scenario over and over again.
Posted by g_g_g_unit on March 5, 2012, at 1:26:04
In reply to Re: Parnate and OCD problems » g_g_g_unit, posted by SLS on March 4, 2012, at 6:55:11
> I don't know the inner workings of OCD. Sorry.
>
> It occurred to me that using clonidine, or perhaps guanfacine, would mitigate the amphetamine-like effect of Parnate and exert an ant-OCD effect.
>
>
> - ScottI guess my concern here isn't so much the obsession, or treating it, but who gets to determine whether it's safe for me to take and/or drink on Parnate, i.e. is there any validity to my being concerned, because I know a lot of psychiatrist would just say "no, don't drink at all on medication," so who can assess my fear and determine whether it is OCD or not?
I guess I'll talk to my therapist this week.
Posted by SLS on March 5, 2012, at 6:57:08
In reply to Re: Parnate and OCD problems » SLS, posted by g_g_g_unit on March 5, 2012, at 1:26:04
> I guess my concern here isn't so much the obsession, or treating it, but who gets to determine whether it's safe for me to take and/or drink on Parnate, i.e. is there any validity to my being concerned, because I know a lot of psychiatrist would just say "no, don't drink at all on medication," so who can assess my fear and determine whether it is OCD or not?
The old list of forbidden foods from the 1970s is not accurate. Too many of the foods and drinks that are listed ended up being safe to consume.
http://www.dr-bob.org/babble/20120221/msgs/1012181.html
- Scott
This is the end of the thread.
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