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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by thebends on August 29, 2005, at 20:20:24
Hello. I've been lurking for a while, and I decided that it's time to finally avail myself of the incredible amount of support and encouragement that members on this forum provide to one another. I'll try to keep this introductory post brief. Feel free to follow-up with questions or comments; I'm sure I left some things out. Here goes... I suffer from chronic, disabling OCD and comorbid social anxiety. I also suffer from frequent mood swings (often several times a day) that may be suggestive of a bipolar spectrum disorder, though I still can’t tell if the recurrent brief depressions and excited moods that I experience are better conceptualized as sequelae of the aforementioned conditions or discrete pathologies. Unfortunately, I've also begun to experience Male Pattern Baldness, and will not take any medication that could even possibly accelerate or exacerbate the condition (though my rapidly deteriorating condition has caused me to reconsider somewhat). Obviously, this greatly complicates my medication options. In the past, I've taken Prozac, Paxil, Zoloft, Luvox, Celexa, Lexapro, Anafranil, Wellbutrin, Effexor, Buspar and (probably one or two others that I'm forgetting), all with limited success. In fairness, the SSRIs did allow me to function (something I can't do right now), but they did little for my OCD. Right now, my treatment objective is to reduce my obsessions/compulsions and increase my sociability. My preference is for medications that can be taken on “as needed” basis (that way I don’t have to worry as much about a medication having a negative cumulative impact on hair loss), but at this point, I will consider medications that have to be taken daily. What do you guys think of the following:
Verapamil: Reputed to have an anti-anxiety effect and mood stabilizing effect, and there are actually theoretical reasons that it might help re-grow hair.
Lamictal: Would probably work well for my recurrent depressions.
Dexedrine: Might help with my anhedonia and increase my sociability.
Morphine: Taken once-weekly for OCD? Did anyone actually try this?
Buprenorphine: I haven’t heard anything about this drug for OCD in a while.
Deprenyl: Again, might help with stimulation/sociability.
Klonopin: Appears to work well for social anxiety, but I’m worried that it may cause depression.
Xanax: I like that some people find it stimulating, but there's not as much support for its use in social anxiety.Thanks so much in advance for any feedback. I look forward to hearing from you guys and contributing to the board in the future.
Posted by utopizen on August 29, 2005, at 20:32:13
In reply to New Here...Severe OCD/Social Anxiety, posted by thebends on August 29, 2005, at 20:20:24
Klonopin, like any drug, cannot actually cause depression. It's reported to in the PDR, since if a patient claims a side effect, doctors simply report it to the FDA, and the FDA must then list it that way.
There's actually studies that it can relieve depression. Medline it.
I swear, it was the thing that did the trick for me-- I was so depressed one day, coming out of my therapist's office, and even weeping on the college bus uncontrollably (it was embarassing) and then I popped my Klonopin for the first time in months (recently having filled it) and, well, no more sulking.. worries... no depressed thoughts. A few weeks into things, I basically entered remission from daily use of it + Lexapro.
Take an SSRI and Klonopin regularly, I suggest. The trick is, don't take Klonopin alone. Take it with an SSRI, and worries begone.
No worries. You'll do fine. =)
I had a terrible time, trust me-- me allowed to pretend happy days do exist.
Posted by thebends on August 29, 2005, at 20:41:52
In reply to Re: New Here...Severe OCD/Social Anxiety, posted by utopizen on August 29, 2005, at 20:32:13
Hi. Thanks so much for the reply and your words of encouragement. Things are indeed pretty bleak for me right now. I will research Klonopin on Pubmed. However, I'd be very reluctant to take it daily because of my concern over hair loss. That said, I would definitely consider taking it on an as-needed basis. What dosage do you use? As for the SSRIs, I won't go near them again. I will take your suggestion under advisement, though :)
Posted by fires on August 29, 2005, at 20:49:06
In reply to New Here...Severe OCD/Social Anxiety, posted by thebends on August 29, 2005, at 20:20:24
I posted recently that my former MD wrote about the use of IV Gamma Globulin for treatment resistant OCD. Although controversial, the treatment has theoretical backing.
Your mood swings and social anxiety along with your apparent non-responsiveness to a bunch of meds could be indicative that you have the "type" of OCD that *might* be helped by IVIG. Then again...
My old docs book: "Tuning the Brain" by Jay Goldstein, MD.
You might Google PANDAS to read more about the relationship between Strep infections, immunity, and OCD. This is mostly about children, but we were all children at one time. :)
The following is from:
http://www.ocdhope.com/PANDAS.htm
" * The presence of accompanying neurological signs such as tics, hyperactivity, or choreiform movements (irregular spasmodic involuntary movements of the limbs or facial muscles) further distinguishes this subgroup of children with OCD.* Other symptoms can include emotional lability (over reactions to minor events), separation anxiety, nighttime fears and oppositional behaviors."
Good luck
Posted by mogger on August 30, 2005, at 1:29:38
In reply to New Here...Severe OCD/Social Anxiety, posted by thebends on August 29, 2005, at 20:20:24
I have ocd/depression as well, all those meds you mention helped me limitedly until my doctor added lamictal. It helped so much with my depression and helped the other meds to start working (200mg of Zoloft), 90mg Buspar, Remeron, Zyprexa.
Let me know if you have any questions, lamictal changed my life after 8 years of trying different meds.
mogger
Posted by Nickengland on August 30, 2005, at 5:27:33
In reply to Re: New Here...Severe OCD/Social Anxiety, posted by utopizen on August 29, 2005, at 20:32:13
Hi utopizen
>Klonopin, like any drug, cannot actually cause depression.
The drug is not the "cause" of depression. What is known about the drug and other drugs too is that it can "induce" depressive like symptoms.
This is called a drug induced depression I believe.
>There's actually studies that it can relieve depression.
As its not the "cure" of depression, I know you didn't say that, but you could also have as many studies showing how it can induce depression too.
Kind regards
Nick
Posted by Sonya on August 30, 2005, at 9:07:20
In reply to Re: New Here...Severe OCD/Social Anxiety, posted by utopizen on August 29, 2005, at 20:32:13
In my case, it most definitely worsened my depression. It also caused nightmares, hallucinations, and depersonalization. BTW, I also took it in conjunction with an SSRI.
I disagree with your statement that no drug causes depression.
Posted by ixus on August 30, 2005, at 12:41:04
In reply to New Here...Severe OCD/Social Anxiety, posted by thebends on August 29, 2005, at 20:20:24
Try Nardil. IMHO most of the listed drugs can only make your symptoms worse.
/ixus
Posted by john berk on August 30, 2005, at 16:06:02
In reply to Re: New Here...Severe OCD/Social Anxiety » thebends, posted by ixus on August 30, 2005, at 12:41:04
Hi!! i have to agree with Utopizen,
klonopin was a real life-saver in my worst days with ocd. i have read quite a few articles that high doses can cause depression, and i do worry about that, but i keep my dose relatively low,[o.5] unless it is a very bad day, then i may take extra, 2 mgs.!!
my friend is looking into tramodal, which is a mild opiate i beleive, which is FDA approved for pain relief, and can be taken on an as needed basis!! some people are trying it for ocd, they did a study at the university of cincinnati 2 years ago, [sorry, i don't have the link available, but you can probaly find it with a google search!!
i think klonopin actually is the only anti-anxiety med with some serotonin affinity, i take it most every day!! it totaly calms ocd thoughts for me, if only for a few hours!! good luck...john
Posted by thebends on August 30, 2005, at 20:34:40
In reply to Re: New Here...Severe OCD/Social Anxiety, posted by john berk on August 30, 2005, at 16:06:02
Thank you to everyone for taking the time to reply. If it weren't for my obsession with hair loss, I'd probably give all the suggestions a try. As it stands, however, I'm severely limited in my approach. I'll keep everyone updated.
Posted by thebends on August 30, 2005, at 20:48:17
In reply to Re: New Here...Severe OCD/Social Anxiety, posted by john berk on August 30, 2005, at 16:06:02
john, I actually am familiar with the use of tramadol in OCD. Do you happen to know the recommended dosing protocol for its use on an as-needed basis? Please keep me updated on your friend's progress. Also, I am encouraged to hear of your success with klonopin. Do you really find that it helps with your obsessions? Or does it just help with the anxiety?
Posted by thebends on August 30, 2005, at 20:54:55
In reply to Re: New Here...Severe OCD/Social Anxiety, posted by mogger on August 30, 2005, at 1:29:38
> I have ocd/depression as well, all those meds you mention helped me limitedly until my doctor added lamictal. It helped so much with my depression and helped the other meds to start working (200mg of Zoloft), 90mg Buspar, Remeron, Zyprexa.
>
> Let me know if you have any questions, lamictal changed my life after 8 years of trying different meds.
> mogger
mogger, That's great news about Lamictal. My doctor would be thrilled if I told him I'd be willing to give it a try. If you don't mind, can you tell me more about your experience with Lamictal. Specifically, I'd like to hear what impact, if any, it has had on your OCD. Unfortunately, because of my concern over hair loss, I'm not willing to augment it with an SSRI, but monotherapy with Lamictal still sounds promising. Thanks in advance.
Posted by john berk on August 30, 2005, at 21:03:11
In reply to Re: New Here...Severe OCD/Social Anxiety » john berk, posted by thebends on August 30, 2005, at 20:48:17
Hi!!
My friend actually hasn't started the tramadol yet, but he gave the doctor information he had found on-line, and she is considering it, she has to do more research!! he wants to take it so badly!! i beleive the dosing is 50 mgs. every 4 hours as needed, i will keep you posted when i speak with him again!!
actually, in my expierence, klonopin has taken the obsessions away about 75% when i take 1mg. or more!! it may not work that way for everyone, but a girl i email in wisconsin swears by it, she says she couldn't bare her ocd without it. but she is on zoloft also!! it is supposed to actually raise serotonin slightly, no where near an ssri, but it does have some efect!!also, i know someone who was housebound with ocd and social phobia, but on 6 mgs. per day of klonopin, she is now married!! 6 mgs. would only put me to sleep for 2 days though, lol!! but it is worth a try at a low dose, no doubt!!!!
i'll let you know more when my friend meets with his pdoc again about the tramadol!! have a great evening...john
Posted by bigscreen on August 30, 2005, at 21:49:43
In reply to Re: New Here...Severe OCD/Social Anxiety, posted by thebends on August 30, 2005, at 20:34:40
is risperdal a good med for ocd
Posted by mogger on August 30, 2005, at 22:57:06
In reply to Re: New Here...Severe OCD/Social Anxiety » mogger, posted by thebends on August 30, 2005, at 20:54:55
My depression/ocd was so bad that I couldn't decipher between the two. I went on the Lamictal over a period of time, as you know you must go up slowly, and I can only describe the feeling that at about 5pm every day my mind began to calm down, almost reset, there was some relief from depression/ocd. The next day I would have the same thing, calmed my over reacting brain down. Then he added buspar which was great however I was reluctant as I had tried it before with no success (without the lamictal) but it has worked superb. The added Zoloft on top of that (didn't work without the lamictal) is heaven sent as well for my ocd. if I had the choice of being bald or stop using zoloft I would choose being bald! :). I was never only on Lamictal, my doctor decided to put me on lamictal while I was on all the other drugs (minus the buspar) as it would have been more tumultuous going off them all at that point (I was doing really badly).
Hope this helps, don't hesitate to ask me anymore questions,
mogger
Posted by theo on August 30, 2005, at 23:17:36
In reply to New Here...Severe OCD/Social Anxiety, posted by thebends on August 29, 2005, at 20:20:24
What do you guys think of the following:
>
> Verapamil: Reputed to have an anti-anxiety effect and mood stabilizing effect, and there are actually theoretical reasons that it might help re-grow hair.
> Lamictal: Would probably work well for my recurrent depressions.
> Dexedrine: Might help with my anhedonia and increase my sociability.
> Morphine: Taken once-weekly for OCD? Did anyone actually try this?
> Buprenorphine: I haven’t heard anything about this drug for OCD in a while.
> Deprenyl: Again, might help with stimulation/sociability.
> Klonopin: Appears to work well for social anxiety, but I’m worried that it may cause depression.
> Xanax: I like that some people find it stimulating, but there's not as much support for its use in social anxiety.I know meds effect people differently, but you may want to be careful with Lamictal making OCD WORSE. I remember when I tried it, during a dose increase of just 25mg I would have episodes of intense OCD. I would hit a pothole in the road with my right tire and literally turn around and have to repeat the incident with my left tire to make them even! I thought I was going to loose my mind. It was HELL. Lamictal is known to cause anxiety/OCD in many people, yet some docs prescribe it for this. It also has a history of pooping out and some people say when you get to higher doses it sticks, but by the time I got to 150mg, I had increased side effects, mainly cognitive where I couldn't remember what I did 5 minutes ago.
Posted by Cairo on August 31, 2005, at 11:46:35
In reply to Re: New Here...Severe OCD/Social Anxiety, posted by utopizen on August 29, 2005, at 20:32:13
Clonazepam is very definitely depressogenic in me, seconded by my PDoc who says he has several patients like this.
Cairo
> Klonopin, like any drug, cannot actually cause depression. It's reported to in the PDR, since if a patient claims a side effect, doctors simply report it to the FDA, and the FDA must then list it that way.
>
> There's actually studies that it can relieve depression. Medline it.
>
>
Posted by john berk on August 31, 2005, at 21:17:55
In reply to Re: New Here...Severe OCD/Social Anxiety, posted by bigscreen on August 30, 2005, at 21:49:43
Hi!! I hear that it is definetly helpful with ocd, but i believe when taken with an ssri!!
i here that risperdal augements ssri therapy quite well!! peace...john
Posted by pro_social_soon on September 1, 2005, at 3:19:45
In reply to New Here...Severe OCD/Social Anxiety, posted by thebends on August 29, 2005, at 20:20:24
Posted by pro_social_soon on September 1, 2005, at 3:20:37
In reply to NARDIL ! (nm) » thebends, posted by pro_social_soon on September 1, 2005, at 3:19:45
Nardil all the way! Best treatment for severe social anxiety/OCD/general anxiety with comorbid depression. Try it , you (I hope so) won't regret!
Take care
This is the end of the thread.
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