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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by coplo on December 3, 2004, at 16:58:22
I have a problem that seems to have been precipitated into a bunch of other problems.
I'll try to be concise but it will be hard.
I initially was diagnosed with OCD 5 years ago and went trough the following drugs for it:
Luvox - worked but some sex side effects
Paxil - Worked best of all, but horrible sex side
Prozac - no imporvement
Zoloft - no improvement- possible mania ensuedAbout two years ago, a different doc suggested that I might gave GAD/SAD and that OCD is just the tip of the iceberg, so we started looking into OCD meds that helped with anxiety as well:
He combined Luvox/Paxil with Neurontin (no help), then went to Remeron (which made me sleep 24 hours a day), then Effexor, which was great except it did not help with anxiety/OCD much , it just made me realize that I might have been depressed!!!?
The strange thing about this whle ordeal is that I keep changing meds and still not getting anywhere and a new problem has developed that I never had in the past- I am consistently fatigued and sleep around 15 hours per night/nothing seems to help, not even coffee.
After stopping all meds, the excessive sleepiness does not go away, which has made me think , I need a med to counteract chronic fatigue!?!!!
A couple of things about my type of OCD (if that is really what it is). All I know is that I definitely need Luvox or Paxil. Trough all the med changes, I have always been on one or another as a safety net. If I don't take an SSRI, I tend to start acting nuts: i realize I'm acting weird towards my friends and family, but I just seem to not be able to draw the line between what is too much. For example, I start acting childish and trow tantrums or start jokingly letting my self be dragged by my roomates leg as he tries to desperately get away as I am laughing histeriacally on the floor grabbing his leg...(is that even OCD?). It seems like my thoughts also start running a million miles an hour when I don't take my SSRI. When I get back on them the world, just kinda slows to a normal speed I never even knew existed (is that OCD?).
So to sum it up, I would appreciate any comments about what my real diagnosis might be, since I'm not so sure it's typical OCD.
I also would like advice on what combo of meds I could take to deal with my current problems: I need soemthing that will keep me calm like the SSRI's, help my anxiety like the benzodiazepines and make me not need to sleep so damn much because I'm not getting anything acomplished in my life anymore (I am even getting depressed cuz I can't get anything done and loosing motivation to do anything with my life due to the failure of the meds to keep me on track)...any help/comments?
thanks
jc
Posted by awatts on December 3, 2004, at 17:27:21
In reply to help with anxiety/SAD and somnolence, posted by coplo on December 3, 2004, at 16:58:22
You said that Effexor worked for your depression, so why not try Effexor XR or Cymbalta and a low dose of a benzo - say .25 mg of clonazepam twice a day. Any additional sedation from the benzo should go away in 2 or 3 weeks. Give both meds time - at least 6 weeks.
Posted by King Vultan on December 3, 2004, at 20:00:13
In reply to help with anxiety/SAD and somnolence, posted by coplo on December 3, 2004, at 16:58:22
You might want to consider one of the MAOIs, perhaps Nardil because it is very serotonergic and also works on GABA as the benzos do. In general, the MAOIs seem to reduce the need for sleep. Parnate, the other major MAOI in the AD class, would be even more likely to do this and causes outright insomnia in many cases.
To me, racing thoughts by themselves are not necessarily an OCD symptom, but they can be related to an anxiety issue; although, there are other conditions also associated with racing thoughts, such as bipolar disorder. I have a problem with racing thoughts myself, but the drugs that have worked best for me as far as slowing down my thoughts and calming me have been the more dopaminergic ones, not the SSRIs. The implication would be that the racing thoughts in my case are more of an ADD symptom. I do have true OCD symptoms also, and I did always find serotonergic drugs such as Zoloft and Effexor relatively effective for those particular symptoms.
Todd
Posted by coplo on December 3, 2004, at 21:24:17
In reply to Re: help with anxiety/SAD and somnolence, posted by awatts on December 3, 2004, at 17:27:21
The Effexor works for depression but does nothing much for ocd/racing thoughts. Do you think something like ritalin combined with paxil would get rid of the somnolence and help with the sexual side efects, and a benzo could be added on top?
Posted by Tom G on December 3, 2004, at 22:51:01
In reply to Re: help with anxiety/SAD and somnolence, posted by coplo on December 3, 2004, at 21:24:17
Three words for you Effexor+Provigil+benzo of your choice.
This is the end of the thread.
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