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Re: Non-SSRI OCD Medications - Help Needed » umberto

Posted by azalea on October 7, 2008, at 15:42:59

In reply to Non-SSRI OCD Medications - Help Needed, posted by umberto on October 7, 2008, at 10:23:15

What you describe is termed tachyphylaxis in the literature. It has been reported in people taking SSRIs for depression. This leads me to believe that it likely occurs with SSRIs for OCD as well.

SSRIs are generally considered the foundation of OCD treatment, however it is not uncommon to achieve incomplete response with SSRI monotherapy. Perhaps you could consider an augmenting agent such as buspirone, an atypical antipsychotic, or lithium.

You could also try a different SSRI. Sometimes another one will work after one stops working. Fluvoxamine (Luvox) might be a good option.

There is also some evidence that inositol supplementation is effective for treating OCD. Doses used in studies ranged from 12-18 grams daily. You can get inositol supplements at health food stores or order from a vitamin store online.

Best wishes.

> I have been suffering from pure-O OCD for the last 15 years. For the first 12-13 years, one or the other SSRI managed to keep the problems at bay enough for me to get through academic life and then work. However, 2 years back, I stopped Lexapro (it was working very well, but I had put on a ton of weight) . I was off medicines for 3 months before I had a huge relapse. Since then, I have tried multiple SSRIs (as well as clomipramine) at high doses but nothing seems to work beyond 60-70% efficacy, which leaves me still significantly disabled and very highly anxious. The last 2 years have been very rocky, and I am completely confused on how to proceed since SSRIs are supposedly the only medicine for OCD.
>
> Can someone relate to my symptoms and sudden med-resistance? I do not have any compulsions, and obsessions are non-content specific ( --- I am obsessed about obsessing , if that makes any sense --- ). I fear sporadic thoughts will arise in my mind which prevent me from attending with full focus on the task at hand. Therapy does not help. Doing anything - work, talking on phone etc. makes the anxiety shoot up. I am currently taking 2 mg clonazepam to combat anxiety, but it is doing a mild job at best, the anxiety is still significant.
>
> Any medicine which acts on the NE system ups my anxiety significantly. Thus venlafaxine and clomipramine have been disasters. I responded to Paxil once but failed to respond the second time around.
>
> If anybody has been in a similar position, what did you do to get out of it?
>
> Thanks for ur help.


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URL: http://www.dr-bob.org/babble/20081006/msgs/856232.html