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Any recommendations on OCD treatments?

Posted by greywolf on April 6, 2004, at 13:33:41

I have OCD,a little heavier on the compulsion side than anything else. It is a long-standing problem that I treated for 5 years ago for about a year, then gave up because the meds didn't seem to help.

Because I recently concluded that also trying to handle being bipolar on my own wasn't turning out to be the smartest idea I've ever had, I went back for treatment several weeks ago. Since then, we've been through a few SSRIs that were too "side effecty", then settled on Wellbutrin SR to at least address the severe depressive episodes. That increased my agitation and the intensity of a later manic period, so we added Xanax. Right now I'm on 200 mg Wellbutrin and up to 3x.5g Xanax each day. Next week I will increase the Wellbutrin to 300 mg/day. I have not seen any therapeutic benefit to the Wellbutrin, but I don't want to jump the gun so I am going to give it a full chance to work given that it doesn't have the SEs (sedation and sexual) associated with the SSRIs, and to avoid the lithium I used to take.

My concern is that during this whole time, the OCD is going essentially untreated. The Xanax may have a minimal effect on the physical twitches that interfere with my day, but it seems to achieve that primarily through dulling my senses. It does decrease anxiety, but that doesn't alleviate the obsessions/compulsions much (e.g., counting, intrusive thoughts, ritualistic behavior [like having to do everything the same way each morning or having to say a prayer the exact same way every time--and starting over when I don't--never doing things in 3s (like taking 3 napkins or using 3 dollops of shampoo) for fear that something bad will happen, constantly flipping a light switch so I don't perform the act on a negative intrusive thought, checking due dates over and over to make sure I got them right, even after I've completed the project, constantly turning back to the previous page to read the last word even though I know exactly what it is--I could go on and on, but you get the drift). Some of this is pretty funny stuff when you step back and look at the ridiculousness of it, but it's not so much fun when you're in the middle of it and can't control it.

So, right now I'm part way through an apparently ineffectual course of Wellbutrin for depression, and the OCD is stronger than ever. I don't want to combine an SSRI to cover the OCD because I can't function on the dosage of SSRI necessary to give any benefit (you name it, I've tried it: Serzone, Paxil, Prozac, Zoloft, Lexapro, Luvox). But I need to try something. Any suggestions?


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poster:greywolf thread:333350
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