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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by ace on April 16, 2003, at 0:32:24
Hi guys!,
I'm feeling a little blue today, because the OCD has been bad. At the same time this worsening has told me to get my fat ass (I'm actually skinny except for my Nardil belly!) into top gear. THIS IS THE DECISION...
1. Nardil + Zyprexa 2.5mg.
2. Discontinue Nardil then start Parnate (monotherapy).Now, I spoke to a friend today at uni who has a lot of psychotic friends. These guys have been on antipsychotics for years. And not always new ones. This one dude was on Haldol for 10 years - NO TD AT ALL. They (3 of them) have all been on them for ages, another guy 10 yrs on Risperdone.
So I'm thinking, while the heck don't I use Zyprexa at 2.5mg for 5 years?
But then again, there is still that risk.
This decision has to be made soon. Lithium, without little doubt, will be ceased tommorrow. 2 days later I will begin Clonidine, but for some reason I don't think it will do much. I'll give it 2-3 weeks and then, if it fails, move on.
ADVICE PLEASE! THIS OCD MUST GO.
Ace.
Posted by lawrence S. on April 16, 2003, at 2:58:56
In reply to HUGE decision for me....please give advice, posted by ace on April 16, 2003, at 0:32:24
Ace, I hate to see you on AP's. I too am on Nardil and I have ocd, and I agree it didn't totally stop the OCD. Talk to your Pdoc about adding a small amount of Anafranil. It's a TCA that is very powerfull for OCD. I'm sure you know that TCA's sometimes can be carefully added to an maoi. For me, fish oil sems to take care of the remaining OCD. Beleive me, I was borderline psychotic a few times with the crazy thoughts that OCD can put in your head. I know what you are going through.
My trial with Parnate was dissapoiting. It is not as effective for anxiety. It made me very tired.
Don't ice your brain with AP's! Hang in there.
Larry
Posted by ace on April 16, 2003, at 3:19:10
In reply to Re: HUGE decision for me....please give advice, posted by lawrence S. on April 16, 2003, at 2:58:56
Check this out - Carbamazepine (mood stabilizer) with Nardil!!! What a thought!
I'm going to search the archives about this one...remember Carbamazepine is only a mood-stabilizer- like Lithium.
I think it's officially contraindicated but so are a lot of things you can mix with an MAOI.
BTW Lawrence I can FULLY understand what you mean when you say the OCD almost drives you psychotic - It's so stinging.
Have you tried to augment yourself?
Let me know what you think dude.
Take Care Mate,
Ace.
Posted by lawrence S. on April 16, 2003, at 10:27:03
In reply to Thanks Lawrence...I just had a brainstorm! » lawrence S., posted by ace on April 16, 2003, at 3:19:10
Carbemazepine sounds like a better idea than the AP. I tried Trileptal which is a metabolite of Carbamazepine and had some good results. Unfortunately for me all mood stabilizers, even fish oil cause me to be depressed. From what I gather Carbamazepine has an effect not all that different from benzodiazepines - which is a plus. Does Topamax mix with an maoi? I read that it is effective for SP,(another option if you are considering antiepileptics for mood stabilization and anxiety). That's all I can think of for now Ace. I'll let you know if anything else pops in my head.
I'm going to augment my Nardil with ritalin. (I also have ADD.) I'll have to sit in the Pdoc's office most of the day. He is going to give me 5mg of Ritalin and then check my B.P. periodically thoughout the day, then up the dose if it the B.P. does't go up.
I'm also trying Magnesium Citrate as an augmenter. I'll let you know how that turns out. Some other options that I'm considering are Sam-e + Nardil
Larry
Posted by McPac on April 16, 2003, at 18:30:57
In reply to HUGE decision for me....please give advice, posted by ace on April 16, 2003, at 0:32:24
"the OCD has been bad"
Ace, Is it mostly the obsessional thinking/thoughts OR the compulsions OR both?
Have you tried the SSRI's (Zoloft, Luvox, etc)?
Have you tried Remeron?
Have you ever tried Anafranil?
Could you increase the Nardil?
Have you tried adding fish oil?
Is it worse for you lately due to increased stress?
Are you taking any supplements (minerals, vitamins, etc.)?
Thanks!
Posted by ace on April 16, 2003, at 22:51:45
In reply to ace,Re: HUGE decision for me....please give advice, posted by McPac on April 16, 2003, at 18:30:57
> "the OCD has been bad"
>
> Ace, Is it mostly the obsessional thinking/thoughts OR the compulsions OR both?For the most part ocd thoughts and cognitive rituals ie. 'bad' thoughts try to push in and say 'yes' to 'pain', I have to think a 'good' though over it to 'cover' myself and stop the pain (which does come in unless i 'protect' myself)
> Have you tried the SSRI's (Zoloft, Luvox, etc)?Zolft - did little. SSRIs I am not a big fan of due to much literature I've read on them.
But in the future maybe Luvox.> Have you tried Remeron?
No, but maybe in the future.
>
> Have you ever tried Anafranil?
Yes, but when I took 25mg it made my derealization and phobic anxiety MUCH worse. I intend to try it again, starting at 12.5mg with concomitant anxiolytic use.> Could you increase the Nardil?
I'm on the highest dose - 90mg. At one stage I got up to 120mg, but I'd rather keep it to 90mg.> Have you tried adding fish oil?
No nothing about this. Please educate me.
>
> Is it worse for you lately due to increased stress?No, I think it's worse because Lithium has finally got up to the correct plasma level - every med that helps OCD seems to worsen it at first - a good sign.
> Are you taking any supplements (minerals, vitamins, etc.)?
Never.
> Thanks!Thankyou, and please add anything more or recommendations based on my answers.
Take Care!
Ace.
Posted by McPac on April 17, 2003, at 23:41:28
In reply to Re: ace,Re: HUGE decision for me....please give advice » McPac, posted by ace on April 16, 2003, at 22:51:45
For the most part ocd thoughts and cognitive rituals ie. 'bad' thoughts try to push in and say 'yes' to 'pain', I have to think a 'good' though over it to 'cover' myself and stop the pain (which does come in unless i 'protect' myself)
>>>>>>>>>>>>Ace, have you ever just ALLOWED the bad thoughts, when they do come, to come....WITHOUT FIGHTING THEM? Fighting them is the WORST thing you can do---it simply FUELS them all the more! Try to 'detach' yourself from the thoughts, NOT by trying to chase them away or resisting them,....try to sit back and 'observe' the thoughts as a spectator would....when they come start taking rythmic breaths---in slowly through your nose, out slowly through your mouth, keep doing that, focus your mind on your heart beating (picture your heart, picture it slowing down, picture the blood slowing down, keep breathing slowly this way, IF the thoughts force their way into your mind DON'T FIGHT THEM...RECOGNIZE the thought for what it is, NOT a rational thought with any logic or real power (it's just the stupid OCD talking it's hogwash again)...LET IT SAY what it wants to say...tell it calmly "yeah, yeah, yeah, you're just ocd, with nothing IMPORTANT or REAL to say (UNDERSTAND that it is NOT a LEGITIMATE THOUGHT, it ONLY has whatever power that you give it! Recognize it as nothing but blabbering chatter! Focus on your breaths, picture your heart slowing down, down, down. But DON'T fight it----tell it (the ocd), "oh, it's you again, well come on in and say whatever you've got to say", LET IT TALK! (When you STOP fighting and resisting it, first, the body will begin to SLOW DOWN and relax RATHER THAN shooting out MORE and MORE adrenaline, which would ONLY serve to make it WORSE!)
> Have you tried the SSRI's (Zoloft, Luvox, etc)?
Zolft - did little.
DOSAGE is very important Ace! Many ocd sufferers take too small a dose and often quit the med BEFORE it begins working. Take a HIGH ENOUGH DOSE and for a long enough period of time before deciding the med didn't work. (OCD often requires a HIGHER dose than depression does for meds).
SSRIs I am not a big fan of due to much literature I've read on them.
But in the future maybe Luvox.It's always a 'balancing act', balancing benefits/side effects....when the OCD gets bad enough, I'd take ANY med that helped (terrible ocd is worse than just about any side effects)
> Have you tried Remeron?
No, but maybe in the future.Some people HAVE had success with Remeron for OCD and it doesn't have many side effects (too high a dose 'can' make some very jumpy, nervous due to increased norepinephrine levels)
> Have you ever tried Anafranil?
Yes, but when I took 25mg it made my derealization and phobic anxiety MUCH worse. I intend to try it again, starting at 12.5mg with concomitant anxiolytic use.Okay
> Could you increase the Nardil?
I'm on the highest dose - 90mg. At one stage I got up to 120mg, but I'd rather keep it to 90mg.Okay
> Have you tried adding fish oil?
No nothing about this. Please educate me.Get some fish oil...take 3 grams total of EPA/DHA combined (you have to add up the combined EPA/DHA and take about 3 grams/day....you could start at 1 gram/day for a week or so, go to 2 grams/day for another week or so, then 3 grams/day...lets your body adjust to it....you need these Essential Fatty Acids)
>
> Is it worse for you lately due to increased stress?No, I think it's worse because Lithium has finally got up to the correct plasma level - every med that helps OCD seems to worsen it at first - a good sign.
Okay
> Are you taking any supplements (minerals, vitamins, etc.)?
Never.Getting tested is BEST, so that you KNOW what your body does.does not need...but if you can't get tested.....(1) take a vitamin-B complex 100 (WITHOUT Folic Acid, as I have read that OCD'ers should avoid folic acid, so unless you know otherwise I'd avoid it for now..also read to avoid copper as well), stress depletes the vitamin-B's badly and you need those! (2) take about 3/grams of vitamin-C a day (1 1/2 morning, 1 1/2 dinner) (3) get some magnesium glycinate....there are other supplements to take/consider also....let me know if you want to hear more about supplements (better yet, go to a Border's book store, find a nutritional book for treating various problems, for example "Nutritional Prescriptions for Healing" by Dr. Balch, for example, start reading about nutrition and diet for helping ocd. Learn MEDITATION, it will calm the mind...yoga, tai-chi, exercise....MANY, MANY things to do to help yourself. AVOID Caffeine and too much SUGAR also!
Take Care!
AceTake Care, God Bless my ocd friend! Learn all you can about the MANY ways to help yourself Ace. READ, READ, READ and LEARN...then JUST DO IT!!!There are MANY ways to skin a cat...and MANY ways to KICK OCD'S ASS!
Posted by McPac on April 17, 2003, at 23:45:16
In reply to Ace,Re: HUGE decision for me....please give advice, posted by McPac on April 17, 2003, at 23:41:28
"DOSAGE is very important Ace! Many ocd sufferers take too small a dose and often quit the med BEFORE it begins working. Take a HIGH ENOUGH DOSE and for a long enough period of time before deciding the med didn't work. (OCD often requires a HIGHER dose than depression does for meds)".
Ace, this goes for any anti-cod med, not just Zoloft.
Posted by ace on April 19, 2003, at 0:49:07
In reply to Ace,Re: HUGE decision for me....please give advice, posted by McPac on April 17, 2003, at 23:41:28
> For the most part ocd thoughts and cognitive rituals ie. 'bad' thoughts try to push in and say 'yes' to 'pain', I have to think a 'good' though over it to 'cover' myself and stop the pain (which does come in unless i 'protect' myself)
>
> >>>>>>>>>>>>Ace, have you ever just ALLOWED the bad thoughts, when they do come, to come....WITHOUT FIGHTING THEM?Thanks for the response dude!
About 2 years ago I was doing intensive therapy on my OCD. Not only was I accepting them, at times I was encouraging them. But the problem is - it made me worse!! For instance, sometimes I think (and have pain) about a 'bad' thought I said 'yes' to 2 yrs ago!!I just find it to scary to go back...it would be different if it helped heaps, but, even at the time, it only provided minimal relief.
At times I got spiritual and thought to accept every part of me - even OCD thoughts. Didn't work.
I just think of it now like a disease which words can't help. If you talk to a broken leg or scratch it it will annoy it. Same with OCD.
But this is my opinion and if it works for you that is excellant. We are all very different and I believe even people with OCD have different oCD's and diff causes.
Fighting them is the WORST thing you can do---it simply FUELS them all the more! Try to 'detach' yourself from the thoughts, NOT by trying to chase them away or resisting them,....try to sit back and 'observe' the thoughts as a spectator would....when they come start taking rythmic breaths---in slowly through your nose, out slowly through your mouth, keep doing that, focus your mind on your heart beating (picture your heart, picture it slowing down, picture the blood slowing down, keep breathing slowly this way, IF the thoughts force their way into your mind DON'T FIGHT THEM...RECOGNIZE the thought for what it is, NOT a rational thought with any logic or real power (it's just the stupid OCD talking it's hogwash again)...LET IT SAY what it wants to say...tell it calmly "yeah, yeah, yeah, you're just ocd, with nothing IMPORTANT or REAL to say (UNDERSTAND that it is NOT a LEGITIMATE THOUGHT, it ONLY has whatever power that you give it! Recognize it as nothing but blabbering chatter! Focus on your breaths, picture your heart slowing down, down, down. But DON'T fight it----tell it (the ocd), "oh, it's you again, well come on in and say whatever you've got to say", LET IT TALK! (When you STOP fighting and resisting it, first, the body will begin to SLOW DOWN and relax RATHER THAN shooting out MORE and MORE adrenaline, which would ONLY serve to make it WORSE!)I think it's useful to say 'It's not me, it's the oCD'
> Have you tried the SSRI's (Zoloft, Luvox, etc)?
>
> Zolft - did little.
>
> DOSAGE is very important Ace! Many ocd sufferers take too small a dose and often quit the med BEFORE it begins working. Take a HIGH ENOUGH DOSE and for a long enough period of time before deciding the med didn't work. (OCD often requires a HIGHER dose than depression does for meds).I took 200mg for almost 3 years. 25mg had the same effect as 200mg!
> SSRIs I am not a big fan of due to much literature I've read on them.
> But in the future maybe Luvox.
>
> It's always a 'balancing act', balancing benefits/side effects....when the OCD gets bad enough, I'd take ANY med that helped (terrible ocd is worse than just about any side effects)Have you considered Zyprexa? I am seeing some outstanding results from it.
> > Have you tried Remeron?
> No, but maybe in the future.
>
> Some people HAVE had success with Remeron for OCD and it doesn't have many side effects (too high a dose 'can' make some very jumpy, nervous due to increased norepinephrine levels)
>
>
> > Have you ever tried Anafranil?
> Yes, but when I took 25mg it made my derealization and phobic anxiety MUCH worse. I intend to try it again, starting at 12.5mg with concomitant anxiolytic use.
>
> Okay
> Yes, I am soon to begin Anafranil. It is a good sign when a med initially makes you worse.
> > Could you increase the Nardil?
> I'm on the highest dose - 90mg. At one stage I got up to 120mg, but I'd rather keep it to 90mg.
>
> Okay
>
> > Have you tried adding fish oil?
> No nothing about this. Please educate me.
>
> Get some fish oil...take 3 grams total of EPA/DHA combined (you have to add up the combined EPA/DHA and take about 3 grams/day....you could start at 1 gram/day for a week or so, go to 2 grams/day for another week or so, then 3 grams/day...lets your body adjust to it....you need these Essential Fatty Acids)
> >
> > Is it worse for you lately due to increased stress?
>
> No, I think it's worse because Lithium has finally got up to the correct plasma level - every med that helps OCD seems to worsen it at first - a good sign.
>
> Okay
>
> > Are you taking any supplements (minerals, vitamins, etc.)?
> Never.
>
> Getting tested is BEST, so that you KNOW what your body does.does not need...but if you can't get tested.....(1) take a vitamin-B complex 100 (WITHOUT Folic Acid, as I have read that OCD'ers should avoid folic acid, so unless you know otherwise I'd avoid it for now..also read to avoid copper as well), stress depletes the vitamin-B's badly and you need those! (2) take about 3/grams of vitamin-C a day (1 1/2 morning, 1 1/2 dinner) (3) get some magnesium glycinate....there are other supplements to take/consider also....let me know if you want to hear more about supplements (better yet, go to a Border's book store, find a nutritional book for treating various problems, for example "Nutritional Prescriptions for Healing" by Dr. Balch, for example, start reading about nutrition and diet for helping ocd. Learn MEDITATION, it will calm the mind...yoga, tai-chi, exercise....MANY, MANY things to do to help yourself. AVOID Caffeine and too much SUGAR also!
>
> Take Care!
> Ace
>
> Take Care, God Bless my ocd friend! Learn all you can about the MANY ways to help yourself Ace. READ, READ, READ and LEARN...then JUST DO IT!!!There are MANY ways to skin a cat...and MANY ways to KICK OCD'S ASS!
>Good on you mate for trying to help - you are a very kind-hearted guy. I just had a laugh when you mentioned to learn heaps about oCD...2 years ago I was obsessed about learning about oCD therapy, I bought heaps of books, every article of the net, etc etc. That was mostly a good obsession. But I always get obsessed about things, even things I like (I gues it's probably OCPD). And boy you should see my Uncle - He is 65 and single - no kids. He loves me to death and gives me heaps of stuff. But boy is he obsessional - Whenever I tell him I'm doing a new subject at uni he literally buys me 40 books on the subject! He started to by me clothes - now I have no room! But he is also a pain in the ass sometimes - he is so rigid, perfectionist in his ways - he won't bend at all! i love him but and always will.
Clearly OCPD!Once again, Take Care dude, thanks so much and keep in touch!!
Ace (Andrew).
This is the end of the thread.
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