Psycho-Babble Medication Thread 1075804

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Re: OCD Dont know where to go

Posted by Bill82 on February 1, 2015, at 13:53:32

In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 13:12:30

At the moment on some antibiotics for a positive test for babes is and bartonella but when I took them I was just on vitamin pill, maybe a probiotic? Don't drink grapefruit juice either. Am Caucasian though, and I will get the DNA tests hopefully tomorrow. Don't smoke cigs anymore and don't smoke pot either, so liver is probably clean in that regard. Main problem with seritonergi a for me is they make me extremely spacy and slow, so much I'll go out to eat and just stare at the menu until the waiter comes and just then realize I'm in a restuarant haha.

 

Re: OCD Dont know where to go

Posted by ed_uk2010 on February 1, 2015, at 13:56:27

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 13:10:41

Hi,

>I tested positive for a MTFHR gene mutation....

Was this done because you were found to have elevated homocysteine levels, or perhaps because you have a family history of cardiovascular disease? I believe mutations are common in people with psych problems too. It's not a particular common test to have though. I suppose you will have seen quite a few different specialists.

I know you don't respond well to Deplin. I assume you've had your folate and B12 levels measured and any deficiencies corrected?
Do you know how you respond to supplements of folic acid, vitamin B12 and vitamin B6 (pyridoxine)?

>Also just got a DNA test done too so maybe that will tell me something.

What have you been tested for? CYP 2D6 status?

>Zoloft was at 50mg for 3 days haha.

Clearly, you can't take Prozac again since you seem to be allergic. And Luvox produced some bad reactions.... so you won't be going there again.

So, Zoloft 50mg made you agitated?

>I get primarily anticholinergic se from them like memory loss

'Anticholinergic' means a drug which blocks muscarinic acetylcholine receptors. Although some of the side effects you've experienced sound superficially similar to certain anticholinergic symptoms, none of the drugs you've taken are strongly anticholinergic and most are not anticholinergic at all. Memantine is not thought to be anticholinergic - your side effects are presumably occurring via a different mechanism. There are many different neurotransmitters and processes involved in memory other than acetylcholine. In addition, norepinephine plays a major role in the urinary tract.

Potent anticholinergic drugs such as tolterodine and oxybutynin have the effect of relaxing the bladder muscle and reducing the urge to urinate. These drugs are used to treat urge incontinence. They do not generally cause dribbling. Dribbling is most common in older men, due to prostate disease, but can occur in younger men due to drugs which constrict the bladder outlet. SNRIs, NRIs and stimulants can do this, via indirect alpha adrenergic receptor stimulation.

It's not clear to me by what mechanism Prozac would cause urinary retention. It's anticholinergic effect is so weak as to be irrelevant, so there must be another cause. It is a very weak NRI, but that doesn't seem a likely cause either. It's confusing.

What were the urinary effects of the SNRI Cymbalta for you?

 

Re: OCD Dont know where to go

Posted by ed_uk2010 on February 1, 2015, at 13:59:53

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 13:53:32

>At the moment on some antibiotics for a positive test for babes is and bartonella but when I took them I was just on vitamin pill, maybe a probiotic? Don't drink grapefruit juice either.

Ah right. I was mainly checking because some meds are potent enzyme inhibitors and can therefore potentiate a variety of different drugs.

>Am Caucasian though, and I will get the DNA tests hopefully tomorrow.

How long will the results take?

>Main problem with seritonergi a for me is they make me extremely spacy and slow, so much I'll go out to eat and just stare at the menu until the waiter comes and just then realize I'm in a restuarant haha.

This isn't an anticholinergic effect. It must be to do with the increased serotonin causing overstimulation of certain serotonin receptors, producing cognitive dysfunction.

Would you be up for trialling a much lower dose? eg. sertraline (Zoloft) 12.5mg/day?

 

Re: OCD Dont know where to go

Posted by Bill82 on February 1, 2015, at 14:01:23

In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 13:12:30

At the moment on some antibiotics for a positive test for babes is and bartonella but when I took them I was just on vitamin pill, maybe a probiotic? Don't drink grapefruit juice either. Am Caucasian though, and I will get the DNA tests hopefully tomorrow. Don't smoke cigs anymore and don't smoke pot either, so liver is probably clean in that regard. Main problem with seritonergi a for me is they make me extremely spacy and slow, so much I'll go out to eat and just stare at the menu until the waiter comes and just then realize I'm in a restuarant haha.

 

Re: OCD Dont know where to go

Posted by ed_uk2010 on February 1, 2015, at 14:20:56

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 14:01:23

>At the moment on some antibiotics for a positive test for babes is and bartonella

Do you have any clinical signs of infection at the moment? Or it is a case of positive antibody tests suggesting past exposure?

Given the appearance of symptoms during a mycoplasma illness, I was wondering whether long-term antibiotic treatment to prevent a similar episode might be appropriate, for example with doxycycline.

 

Re: OCD Dont know where to go

Posted by Bill82 on February 1, 2015, at 14:51:22

In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 14:20:56

Yea it had both igm tests positive and still have very high miycoplasma titers that are slowly coming down. It might be a thought, currently on minocycline which is a glutamete reuptake enhancer, and I think it might help a little but maybe just placebo. Also of note I had trialled memantine twice before without adverse effects but now that I tried minocycline I got the side effects. Also low dose sertraline is a thought but it caused pretty bad agitation and restlessness had to move, heart rate at 110bpm sitting etc. I should hopefully get all the results tomorrow, they tested for all common genetic causes of adverse reactions to psych meds I beleive. The mtfhr was done without my knowledge actually, just saw I was tested and was positive. Vitamin b usually dosnt do all that much that I can tell, tried high dose inositol and only got extreme explosive diahrea, kept with it but didn't notice any benifit. Now that I think about it memeory is probably something than anticholinergic even though as I don't get dry mouth very bad, except a little on luvox but it didn't bother me.

 

Re: OCD Dont know where to go

Posted by ed_uk2010 on February 1, 2015, at 15:02:28

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 14:51:22

>....on minocycline which is a glutamate reuptake enhancer, and I think it might help a little but maybe just placebo.

I suppose the main benefit will be to help prevent re-infection. Hopefully, in the absence of further infections your symptoms will improve substantially over time.

>low dose sertraline is a thought but it caused pretty bad agitation and restlessness had to move, heart rate at 110bpm sitting etc.

I think you're a risk for severe side effects with all SSRIs at standard doses. The side effects are dose-dependent though.

Did you get any agitation on Lexapro?

>I should hopefully get all the results tomorrow, they tested for all common genetic causes of adverse reactions to psych meds I believe.

Let us know the results.

>Risperidone

The side effects you experienced sound fairly severe. What dose were you taking and how did it affect your OCD? Did you take it alone or in combination with an SSRI?

 

Re: OCD Dont know where to go

Posted by Bill82 on February 1, 2015, at 15:15:30

In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 15:02:28

Risperidone was lowest dose possible then cut in half and it caused severe rage/anger mixed with extreme drowsiness and depression, also did squat for ocd sadly. As for lexapro really bad impotence haha was extreme but the main reason I stopped was it like brintillex induced depression, which I normally don't have, just got ocd, and I will it might be two weeks now that I think if it but I will definitly post. Was just reading a new drug for depression that acts on opiate receptors, you heard of it? It's a combo of two medicines, bupreniphone and samidorphan I believe

 

Re: OCD Dont know where to go

Posted by ed_uk2010 on February 1, 2015, at 15:33:51

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 15:15:30

Well, I can see why you'd be reluctant to try SSRIs again, but I do think it might be worth trying a much lower dose... of Lexapro or Zoloft. Since you are very sensitive to the toxicity of these drugs for whatever reason, it is possible that a very low dose may turn out to be therapeutic. Whatever standard doses are doing, it's not what you need.

You could consider Lexapro, 2.5mg/day initially, then 5mg after a couple of weeks, if 2.5mg was well tolerated. For Zoloft, you could try 12.5mg initially, then potentially 25mg if tolerated. I don't know what your doctor would think of this strategy. It is at least a very simple thing for you to try.

>Buprenorphine/samidorphan

I have heard of it yes. In fact, I was discussing it with Hello123 above.

>Risperidone was lowest dose possible then cut in half and it caused severe rage/anger

Are risperidone and mirtazapine the only drugs to cause this anger in you?

 

Re: OCD Dont know where to go

Posted by Bill82 on February 1, 2015, at 15:39:09

In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 15:33:51

Would be tempted to try the ssri again, but even at 15mg of vortioxetine for a whole I achieved very little reduction in ocd. But I will have to ask what they think. And so far yes, it was pretty scary too. Risperidal also caused bad salivation which was unpleasant

 

Re: OCD Dont know where to go

Posted by ed_uk2010 on February 1, 2015, at 15:50:34

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 15:39:09

>Risperidal also caused bad salivation which was unpleasant

Dopamine antagonists can cause hypersalivation, but to experience it at such a low dose is unusual. It's more commonly seen with high doses of older neuroleptics such as haloperidol. In fact, you could be extremely sensitive to haloperidol, so it may be a good idea to avoid it entirely for now.

>tics...

Clonidine, which is sometimes used to suppress tics, also appears to acutely reduce OCD symptoms - even after a single dose. Whether it has any sustained effectiveness in OCD is unknown. Assuming you do not have low blood pressure, you could potentially try it.

http://www.ncbi.nlm.nih.gov/pubmed/1876628

'Following clonidine, but not following placebo, patients transiently experienced a significant reduction of obsessions and compulsions.'

 

Re: OCD Dont know where to go

Posted by ed_uk2010 on February 1, 2015, at 15:54:15

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 15:39:09

I can see why you'd be cautious about trying further SSRIs if prolonged vortioxetine treatment was ineffective.

Since clonidine appears to work rapidly, I wonder what your doctor would think of trying it? In psychiatry, it's mainly used for tic disorders, and occasionally for reduction of hyperactive/impulsive behavior, but prescribing for other uses does occur. Clonidine was traditionally used for high blood pressure but has been replaced by other medications for this purpose.

 

Re: OCD Dont know where to go

Posted by ed_uk2010 on February 1, 2015, at 15:57:32

In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 15:50:34

Anyway, has any of this helped you feel a bit of optimism about treatment options?

 

Re: OCD Dont know where to go

Posted by Bill82 on February 1, 2015, at 20:00:23

In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 15:57:32

Yea you've been a great help I've been eager to check my email all day haha thanks a lot man! As for clonidine I have thought of it, I do have slight low bp due to pots syndrom, but at this rate that is not a deterant, I'll just have to eat more salt. Little worries about impotence but that's just my ocd talking. Too bad ocd dosnt have more options besides ssris in literature. I was just reading a paper on how opiates are particularly effective in ocd with tics, and I can certainly say the morphine they gave me in the hospital obliterated my ocd and especially my doubt which was great. But we know where that goes.

 

Re: OCD Dont know where to go

Posted by ed_uk2010 on February 2, 2015, at 6:58:24

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 20:00:23

> Yea you've been a great help I've been eager to check my email all day haha thanks a lot man!

Oh that's good!

>As for clonidine I have thought of it, I do have slight low bp due to pots syndrome, but at this rate that is not a deterant, I'll just have to eat more salt.

You wouldn't necessarily need to eat more salt. Clonidine does not always cause much postural BP drop, you would have to try it and find out. It tends to reduce heart rate slightly. So long as you started with a low dose and adjusted cautiously it should not be dangerous. After long term use, clonidine needs to be withdrawn gradually.

>Little worries about impotence but that's just my ocd talking.

If you do find an effective treatment and suffer erectile dysfunction you could always use sildenafil or similar. I get the impression that with the current severity of your OCD it would be difficult to put erections to good use anyway, so you may as well concentrate on dealing with the OCD first.

>I was just reading a paper on how opiates are particularly effective in ocd with tics, and I can certainly say the morphine they gave me in the hospital obliterated my ocd and especially my doubt which was great.

Effective briefly but you need something long term. Furthermore, extended use would probably lead to hormonal disturbances and more erectile dysfunction.

 

Re: OCD Dont know where to go

Posted by Bill82 on February 2, 2015, at 10:17:30

In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 2, 2015, at 6:58:24

Any thoughts on naltrexone? There's one study that found it to be useful. I don't think it would cause hormonal imbalances but I could be wrong

 

Re: OCD Dont know where to go

Posted by ed_uk2010 on February 2, 2015, at 11:13:41

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 2, 2015, at 10:17:30

> Any thoughts on naltrexone? There's one study that found it to be useful. I don't think it would cause hormonal imbalances but I could be wrong

Naltrexone is an opiate blocking drug. It may be helpful for impulse control disorders eg. pathological gambling, but I don't think it's normally helpful for OCD.

How are you doing today?

 

Re: OCD Dont know where to go

Posted by Bill82 on February 2, 2015, at 11:22:41

In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 2, 2015, at 11:13:41

Yea that's what i figured. Ocd is pretty bad, drs keep canceling my opointments so just waiting really to get back to them and see what they say. I kind of think they are running out of potential things to try and are kind of fillabusting, but I could be weong( I hope I am actually haha).

 

Re: OCD Dont know where to go

Posted by Bill82 on February 2, 2015, at 11:24:50

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 2, 2015, at 11:22:41

Some new compulsions are starting to suchc as saying stop when I have bad thoughts and suddenly stopping when walking because something dosnt feel right. Weird disease

 

Re: OCD Dont know where to go

Posted by Bill82 on February 2, 2015, at 11:25:30

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 2, 2015, at 11:24:50

How are you doing recently?

 

Re: OCD Dont know where to go

Posted by ed_uk2010 on February 2, 2015, at 12:10:25

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 2, 2015, at 11:25:30

I'm not too bad thanks, things are reasonable. I have side effects from a lot of meds but not too many from SSRIs. Mind you, I have been on one or another for almost two decades, plenty of time to get used to them.

I suppose the advantage of saffron is that you can start treatment yourself. It is rather expensive though....

 

Re: OCD Dont know where to go

Posted by Bill82 on February 2, 2015, at 17:47:19

In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 2, 2015, at 12:10:25

Glad you are feeling ok, side effects are a real pain. I just ordered some so I'll have to try it out. Have you ever heard of tianeptine?

 

Re: OCD Dont know where to go

Posted by Michael Bell on February 2, 2015, at 22:43:56

In reply to OCD Dont know where to go, posted by Bill82 on January 30, 2015, at 20:56:23

Take it from someone who had extreme hypochondriasis and obsessive/ruminative tendencies. I've been on everything. For daily medication, nothing works better than clomipramine. For anhedonia/low mood/OCD, ketamine infusions are damn near miraculous.

 

Re: OCD Dont know where to go ยป Bill82

Posted by ed_uk2010 on February 3, 2015, at 6:36:02

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 2, 2015, at 17:47:19

>Have you ever heard of tianeptine?

Yes. I've never been on it but I am familiar with it.

 

Re: OCD Dont know where to go

Posted by Hugh on February 4, 2015, at 11:42:29

In reply to OCD Dont know where to go, posted by Bill82 on January 30, 2015, at 20:56:23

Deep TMS press release:

The double-blind, placebo-controlled study involved a total of 25 OCD patients that had previously failed to respond to both pharmacological and psychological therapy.

The clinical results showed an average improvement of 27% in symptoms of patients in the high-frequency treatment group, which was significant relative to the sham-control treated group (p=0.0003).

http://www.brainsway.com/press_release/brainsway-reports-positive-final-results-study-using-deep-tms-treat-ocd

From Yale Daily News:

Researchers at the Yale School of Medicine studying obsessive-compulsive disorder are moving closer to personalizing treatments to individuals brains.

The researchers are the first to use functional Magnetic Resonance Imaging to predict whether neurofeedback a technique in which patients are shown a real-time graph of their brain activity while they experiment with various treatment techniques will work for certain patients. Using 13 patients, researchers found that individuals with a stronger connection between the orbitofrontal cortex, a region responsible for decision making that also becomes hyperactive when people become abnormally anxious about dirt and grime, and the rest of the brain respond better to neurofeedback.

Some people will have a certain brain pattern and respond to certain types of treatment, while others will have a different brain pattern and respond to different types of treatment, senior author and assistant professor of diagnostic radiology at the Yale School of Medicine Michelle Hampson said.

http://yaledailynews.com/blog/2014/10/21/neurotherapy-more-successful-for-some


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