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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by kilo8 on June 11, 2015, at 21:53:43
What if SSRI do not help the OCD then do you still need to take antidepressants which boost serotonin simply because you have OCD and OCD has something to do with serotonin?
Would going on a pure NDRI or NRI would make the OCD worse?
These are general questions I ask myself cause I know that I have OCD but from what I can tell SSRIs don't seem to help me. They also don't help with anxiety or depression.
But I don't know if I should then simply move on to tricyclic NRIs or if this would make no sense. If going by theory this would make no sense then I wouldn't even have to try it.Already tried wellbutrin and cymbalta and they didn't work either.
Posted by rjlockhart37 on June 11, 2015, at 22:51:37
In reply to Do you need a serotonergic AD when you have OCD?, posted by kilo8 on June 11, 2015, at 21:53:43
SSRI's are vary good for OCD, prozac, lexepro, and not sure about paxil,, but they do something to serotonin that's in OCD, maybe there's not enough serotonin and makes someone get obsessed over things, wellbutrin would make OCD a nightmare, there is some studies that d-amphetamine is good for OCD, but .... yea
i think the serotonin makes someone feel like things are alright with everything and not to keep obsessing over something......it has a serene feeling....
r
Posted by joe f on June 12, 2015, at 6:24:33
In reply to Re: Do you need a serotonergic AD when you have OCD?, posted by rjlockhart37 on June 11, 2015, at 22:51:37
how about snri's?
Posted by Christ_empowered on June 12, 2015, at 7:03:00
In reply to Do you need a serotonergic AD when you have OCD?, posted by kilo8 on June 11, 2015, at 21:53:43
anafranil? that's still fairly standard treatment...
Posted by SLS on June 12, 2015, at 7:29:33
In reply to Do you need a serotonergic AD when you have OCD?, posted by kilo8 on June 11, 2015, at 21:53:43
Risperdal or Abilify added to either Luvox (fluvoxamine) or Anafranil (clomipramine)?
OCD requires higher dosages of SSRIs and more time to elicit a response. For instance, Prozac (fluoxetinea) is often worked up 60 mg/day and higher for three or more months.
Reducing glutamaate might be helpful when treating OCD. Drugs that do this include memantine, riluzole, and N-acetylcysteine (NAC). NAC might take several months to work. Ketamine has been proposed as a treatment.
- Scott
Posted by kilo8 on June 12, 2015, at 20:18:13
In reply to Re: Do you need a serotonergic AD when you have OCD? » kilo8, posted by SLS on June 12, 2015, at 7:29:33
Hello,
I was on 300mg wellbutrin and I dont remember that it made me feel worse but also not better.I was on cymbalta up to 120mg, did nothing for me!
I was on lexapro 20mg for 4 months didn't work but caused HUGE withdrawals.
I was on anafranil 75mg for 1 month the side effects were too strong my heart was racing all the time so I had to get off it.
I feel like SSRI/SNRI are not going to work for me. But the TCA all the the same side effects like anafranil and if anafranil wasn't tolerable for me then amitritypline and others will be the same. Also TCAs are even less mixable with d-amph and I am trying d-amph for ADD.
It's a very complicated situation and I have to figure this out on my own cause my doc makes no suggestions. He has way too little time for this.
If I do not know what I want when I go to him then the whole visit is useless. He will simply suggest whatever comes to his mind and this usually doesn't work either.I really dont even know if ANY drug out there can help me.
I also tried 600 mg NAC but I cannot say that I felt better. I read NAC can also increase glutamate maybe this is bad for me.
I would rather like to try Lamictal but my pdoc declined. He said he thinks this isn't right for me. :/
I can only say that the antidepressants don't seem to help me with my key issues which are:
depression
anxiety
restlessness/clear mind
ocdAnd I'm also scared that d-amph might not help me with my ADD either. Ritalin certainly does not.
I basically get nothing done. Every day is the same. I am so undirected and unproductive. I am totally tripping on the spot and every day I do the same destructive things which do not help me AT ALL but I am stuck with them. I feel like every other person in my place could make much more progress than I can. I just hate it.
Posted by herpills on June 13, 2015, at 10:36:46
In reply to Do you need a serotonergic AD when you have OCD?, posted by kilo8 on June 11, 2015, at 21:53:43
Have you ever tried Remeron? (mirtazapine)
Posted by phidippus on July 14, 2015, at 20:04:41
In reply to Re: Do you need a serotonergic AD when you have OCD?, posted by kilo8 on June 12, 2015, at 20:18:13
>I was on cymbalta up to 120mg, did nothing for me!
Not a high enough dose. Try 320 mg
>I was on lexapro 20mg for 4 months didn't work but caused HUGE withdrawals.
Not long enough on it and not a high enough dose. Try 40 mg for 8 weeks for response.
>I was on anafranil 75mg for 1 month the side effects were too strong my heart was racing all the time so I had to get off it.
I was on 300 mg to treat my OCD effectively.
>I feel like SSRI/SNRI are not going to work for me.
You're not on them long enough and you aren't taking an adequate dose. Try the rest of the SSRIs/SNRIs.
>I read NAC can also increase glutamate maybe this is bad for me.
NAC is a glutamate inhibitor. Glutamate inhibition proves therapeutic for OCD.
Try Luvox, it can be very effective in treating OCD. Titrate up to 300 mg for 8 weeks.
ADD
An atypical antipsychotic if you don't have enough response to the Luvox.
If still no response add a glutamate inhibitor such as: Keppra, Lyrica, Neurontin, Riluzole, Zonegran, Lamictal, Topomax.
Eric
Posted by SLS on July 15, 2015, at 8:11:57
In reply to Re: Do you need a serotonergic AD when you have OCD? » kilo8, posted by phidippus on July 14, 2015, at 20:04:41
> If still no response add a glutamate inhibitor such as: Keppra, Lyrica, Neurontin, Riluzole, Zonegran, Lamictal, Topomax.
Is there a particular order that you prescribe these?
- Scott
Posted by phidippus on July 15, 2015, at 11:33:03
In reply to Re: Do you need a serotonergic AD when you have OCD? » phidippus, posted by SLS on July 15, 2015, at 8:11:57
Topomax and Riluzole have the most data backing their efficacy. Lyrica has some case studies backing its efficacy and double blind studies are under way. Lamictal, Keppra and Zonegran have anecdotal evidence supporting their efficacy.
I hope that helps.
Eric
This is the end of the thread.
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