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Re: TO CAM: NEED HELP; SOMEONE PLEASE ANSWER; OCD

Posted by Angela on June 5, 2000, at 9:59:25

In reply to Re: TO CAM: NEED HELP; SOMEONE PLEASE ANSWER; OCD, posted by Cindy W on June 4, 2000, at 23:10:08

Cindy,

thanks for your input about the response time. i am having a really hard time right now and it seems like things are getting worse instead of better. i'm currently unemployed and looking for a job, but its very difficult to do this when i don't want to get out of bed and have no desire to do anything.

i have mostly obsessions, and right now they're about my husband, which is quite disturbing and frightening. ironically enough, i feel most safe and comfortable when i'm with him. during the day when i'm home by myself, i'm a mess. i have cold sweats a lot and just a general feeling of yuck! i feel better also when i see or talk to my pdoc, but i realize i can't talk to or see him everyday. i'm seeing him once a week and that should be more than enough, but sometimes i feel like its not.

when i talked to him on sunday, my pdoc said to just be patient and he knows that depression and OCD suck and things will get better. he keeps trying to think of new meds to add to what i'm taking and i don't want to keep taking more meds, especially if they're not necessary. his other "solution" is to check me into the hospital for a week or two, which neither of us wants me to do.

when i go to sleep at night, i'm usually fine - calm and not obsessing that much. but when i wake up, it all starts again and i'm miserable. i want to cry, but i know that won't help. it might make me feel better for a while though! :)

sorry to babble on like this, but its nice to talk to someone who has OCD and understands what its like. thanks!


CAM - thanks for responding!
> >
> > the reason for the changing meds in such a short amount of time is that my doctor felt they weren't helping. i know we didn't stay on them long enough, but my main problem is OCD, not depression. when one of them is present, the other one is too. i wasn't feeling much relief with the obsessing on the meds we tried and he started changing meds. i was usually crying or feeling very down when i saw him and he was trying to make me feel better, so i think this is why he changed the meds so much. we both knew that we should wait longer on the meds, but i think he felt like i was barely hanging on and wanted to try to find a quick fix.
> >
> > the final change from luvox back to zoloft was my suggestion since i had been on it before and it helped tremendously.
> >
> > i talked to my pdoc today and asked him about the waiting period and he said that for OCD, it takes between 8 & 12 weeks for zoloft to kick in. that made me feel better, only because i thought that since i have been on it for 3 weeks and am still obsessing and feeling down that there was something wrong and i wasn't responding to the zoloft.
> >
> > thanks again for the response, i really appreciate it! :)
> >
> >
> > > Angela - You may still have to give the Zoloft a few more weeks. Why have you been going through so many different antidepressants in such a short time? (side effects?)
> > >
> > > The SSRIs are mostly unrelated chemically. They all (even Celexa to a small degree) bind to other receptors than the serotonin reuptake receptor. Some feel that these other receptors contribute to the differences in efficacy seen between the SSRIs. Perhaps it is one of Zoloft's effects at another receptor site that helped your depression before.
> > >
> > > I am still not convinced (and become less convinced everyday) that the increase in serotonin is the main mechanism of action of antidepressants in all (or most) forms of depression. There are just too many exceptions to the rule (eg Wellbutrin, desipramine). Now, this could be due to different biochemical breakdowns or we could be looking at the wrong site for a mechanism of action. Scientists can deplete the human body of serotonin, but this does not lead to the development of depression; the same can be said for norepinephrine, (something else is going on) but adding a drug that blocks serotonin reuptake (and thus increasing synaptic srotonin levels) relieves depressive symptoms in many people. Is this increased serotonin only an artifact of a closely related system that "is" relieving the depressive symptoms. Just because we see increased serotonin levels with antidepressants doesn't mean that it is the serotonin is "fixing" the depressive symptoms.
> > >
> > > Therefore, "your" response to Zoloft in the past may not be due to serotonin, but to another (possibly minor and to date unknown) mechanism of action of Zoloft. If this were the case, then because you have not responded to other SSRIs and even though serotonin levels have been raised, the proper "fix" for you has not kicked in with the Zoloft yet.
> > >
> > > Again, why did you not give adequate trials to the other antidepressants (eg 8 weeks)?
> > >
> > > Other people can have sequential effect from different SSRIs taken successively in a short period of time, but their depressions could in fact be related to a serotonin breakdown. Perhaps yours isn't. (Is it a chicken/egg thing or is it a chicken/turkey thing?)
> > >
> > > Hope this helps - Cam
>
> Angela, Cam's response was really well put. I have OCD as well as secondary depression, and have found that the maximum benefits for the meds take a long time (8-l2 weeks or even more). Have tried Prozac, Luvox, Serzone, and Zoloft, and now am taking Effexor-XR 375 mg/day, plus Serzone 50 mg/day at night. Are you also receiving behavior therapy or cognitive behavior therapy? There are some kinds of this you can do yourself, too (there are a number of self-help OCD books, and also be sure to check out www.ocfoundation.org). As someone with OCD (obsessions and lots of time-consuming rituals), I have been really frustrated with getting on the right meds, but it's worth it, so hang in there, Angela!--Cindy W


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poster:Angela thread:35842
URL: http://www.dr-bob.org/babble/20000603/msgs/36107.html