Posted by Questionmark on May 14, 2011, at 23:53:15
In reply to Need to figure out meds to take for SA and OCD, posted by Chris2011 on April 21, 2011, at 14:16:44
i know all about OCD perfectionism. And SA. What a paralyzing curse to have one, let alone both.
i understand why you're struggling w the medication decision. i have been stressing about it for a long time (whether i should go off my med, etc.).
i don't know if you need medication or if psychotherapy would be sufficient, at least with what you're on now. If you think there is a decent chance it could be sufficient, then you should probably try that first.
However, I hate to recommend medication when not needed, but it does sound like it may be in your best interests to go farther down the medication route.
I hate -- hATE -- the side effects, the potential long-term physical effects, the stress over the confusion of who is my "true" self, and other things, that my medication brings. But when i look back on the last decade, the best periods were when i was on a full dose of my med.
If you are going to go the medication route, i recommend the same drug that i use and have found to be bar-none the best: Nardil. I tried Parnate before Nardil, and the difference was night and day. Nardil was far better for my anxiety and fear, far better for my depression, and far ... less bad, for my OCD/perfectionism.
One thought:
For me, SSRIs were grossly inadequate. Sure they help a little with OCD, but it's because you care so much less about EVERYthing. Your ability to feel pleasure is also greatly diminished. And it was only moderately helpful for my anxiety and depression. ... So, for me, SSRIs did not cut it (nor any of the augmenting attempts). That said, if you think a full dose of Lexapro might be helpful for you, then try that.
Otherwise, my suggestion would be Nardil.Nardil is a miracle drug for depression. Literally. A miracle within a pill.
It is a miracle for SA -- though it leaves something to be desired compared to its antidepressive effects. Not perfect, but miraculously helpful.
Unfortunately, it is Not very helpful for OCD. It helps with a lot of the negative ruminating associated with depression, but not much more. In fact, in some ways my compulsive perfectionism is much worse-- though my assumption is it is not a direct result of the drug, but a result of being less depressed and having the ability to care about things more.
So/But, if you DO go on Nardil, or any other drug for that matter, get good therapy. It is imperative. Your OCD will not improve, and the other stuff will only be better with the drug. If you don't get therapy as well. Don't be like me and procrastinate this year after year.
I hope this was helpful. Good luck.
PS Oh and if you ever happen to find any really good therapists or programs/ what have you on the east coast, please let me know. I am desperately searching.
> I have multiple mental health conditions that have been affecting my life for years now (OCD, social anxiety disorder, depression, mild paranoia) and I have not taken medication(s) mainly due to my OCD obsessions about the meds and partly because of not being able to tolerate the side-effects. I'd go into detail about the obsessive thinking about the meds but it's difficult to explain and wouldn't make much sense. In short, I have obsessions about the neurotransmitters that a certain med might affect and if I take a med and I'm not sure if certain neurotransmitters are being increased/decreased then my thoughts are interrupted when I interact with others. I'm pretty certain this is the OCD and social anxiety interacting and .....
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> Anyway, I'm at the point of desperation and I don't care about the OCD fears about the medications anymore. I just want to take a med and stick with it for a month or so. Something I've been so fearful of for literally 10+ years due to OCD fears. I've been on Lexapro 2.5mg and klonopin .25mg 4x's a day for the past 3 years, which has sort of stabilized me but I'm still barely treading water. The only other meds I have been able to give an adequate trial are Paxil, all the the Benzos, all the natural supplements, and Anafranil. All of which I couldn't tolerate. The Anafranil did help with OCD but I couldn't tolerate the apathy and somnolence that came along with it. I tried Parnate on a few occasions but only for a day or two. This is the one med I feel would help me significantly as it would address my severe social anxiety and OCD. I know it's not usually prescribed for OCD but I've read several posts on this site from OCD/social anxiety sufferers who have benefitted from Parnate. My main concern is that I don't think I can handle the increased anxiety from the med in the first few weeks of taking it. My anxiety is already bad enough and from past med trials, the increased anxiety has always resulted in embarassing social interactions which then causes me to quit taking the med.
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> From brief trials of other meds of all classes, and from the extensive internet research I've done on meds, the only other meds I will try are Anafranil (again) and Abilify (for the mild paranoia and to see if my social anxiety is actually a form of psychosis - My social anxiety is a feeling of being watched and criticized/judged when speaking to others). I've already tried to increase the Lexapro dose to a "therapeutic" level (15mgs for 6 weeks) but it didn't make any difference. I know that agonizing about which medication(s) to take is part of my OCD perfectionism. I also know that meds might not even be the answer and that there is a lot to be said for cognitive therapy, exposure, exercise, etc. Especially CBT and exposure for the social anxiety. If you're reading this you can probably sense my extreme frustration in trying to figure out the perfect answers to my problems, which is why I'm posting on this message board that I've been reading for years but never thought to post and ask for help and advice.
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> If anybody out there has any ideas, advice, insights, please let me know. I'm sure I'm missing something. Paralysis from analysis I guess. I need to get my life on track. Thanks for reading and thanks in advance for any responses.
poster:Questionmark
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URL: http://www.dr-bob.org/babble/neuro/20100607/msgs/985342.html