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Re: OCD

Posted by yxibow on September 22, 2008, at 2:11:51

In reply to Re: ocd, antipsychotics... » med_empowered, posted by Kimbersaur on September 21, 2008, at 21:34:49


> Well when I first started taking the Abilify the thoughts weren't a huge problem and the Abilify didn't make any noticeable difference. It did (and continues to) help with the contamination OCD somewhat, but mostly it has had the pleasant effect of raising my moods and productivity. The intrusive thoughts now are worse than they were before I started the Abilify, although my stress level is slightly worse as well.

Which is why cause and effect aren't always what they appear to be -- the placebo effect and your own stress level can vary regardless of a medication that hasn't reached a blood level.

> > Have you tried other meds, like benzos, stimulants, TCAs, etc.? I'm just asking because antipsychotics aren't really first line for OCD-type probs, and there are lots of meds out there that are safer, cheaper, and have more data behind them. There's also talk therapy and self-help and nutritional methods that you could explore.

They're not first line but they are augmentative for severe OCD. Still, CBT, behavioural therapy, has been shown to be just as effective. But sometimes people have OCD that exceed the Y-BOCS measurement scale and augmentation of a small dose of a low potency neuroleptic may help.


> I've tried many SSRI's and SNRI's - all of them had sexual side effects (one's that are intolerable for me). I tried Anafranil but a million side effects hit me like a ton of bricks and I had to stop after just a few days. I do take inositol (a supplement) but it doesn't do a whole lot for me and I've made an appointment with a therapist. I may just try Cymbalta next time (it really helped my OCD), with Wellbutrin for the side effects.

Its good that Cymbalta helped with OCD -- for me, I can't really say so, generally NE things seem to aggravate anxiety -- it did help to some extent major depression and I was on it for quite a while.

Wellbutrin for me would definitely aggravate OCD, that I know. But that's just my experience.


> > One thought...I think Abilify takes about 2 weeks to reach a steady state in the blood stream; the effects you see after that time might be a better indication of how Abilify is going to work for you than the very early part of treatment. Also, if you're a slow metabolizer, your low abilify dose could be building up (thanks to the long half life of abilify)..there are a couple reports online of people getting toxic blood levels of abilify off of therapeutic doses b/c of slow drug metabolism......
> >
> > apparently, since abilify is relatively free of EPS and other obvious side effects usually associated with antipsychotics, you can get high blood levels and not even know it.

Relatively for some -- I had major akathisia with Geodon and a fair amount with Abilify (or was it the other way around -- I dont remember).


> So the fact that the worse thoughts didn't kick in for two weeks does not negate the possibility that it is the Abilify causing them? That's very interesting! That's exactly what I wanted to know. I also have another possible side effect (digestive) that didn't kick in for a week so I thought it must be something else. Thanks for the info.


Exactly, causality is not necessarily causation, although I question it at times when I know certain things have happen with medication, but it is one of the tenets of medicine in general.

-- regards

Jay

 

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