your views on medication

[Guest Lotty]

Hi all, I hope you're doing okay. I wanted to know your opinions on something. I've been thinking about medication and ocd, and while I know response is individual and that cbt is crucial, I imagine there are some medications which are overall more effective for ocd than others. Which drugs have you tried and did they help? I have tried clomipramine and sertraline, both worked perfectly for a while, but gradually the doses increased. I wonder why such high doses are required for ocd? Have a good day everyone xx

[Guest yinyang]

Hi lotty,

On the main OCD-UK site there is a list of recommended SSRIs for OCD, have you seen it?

If those medications worked why did you get taken off them? Did they stop working?

I have terrible side effects with SSRIs, so there you go, there's conflicting advice already!

My point is everybody is different, so where as people may post with medications that work for them, it doesn't mean they will necessarily work for you, so really can anybody offer a solid recommendation? Bear that in mind.

I'm guessing there will be a wide variety of medications used by people here, I may be wrong.

My advice would be that if medication is the route you want to go down, work on a trial and error basis with your GP until you find one that works best and stick with it!

[Guest Lotty]

Hi, thanks for your reply, I am still on Sertraline, I have recently increased to 200mg, so am hoping this will have some effect. I came off clomipramine as the side effects were awful and I my ocd wasn't very well controlled. Doctors have mentioned anti psychotics to me a few times, which scares the hell out of me due to the potential side effects. I'm also concerned that these aren't normal treatment for ocd, are they? x

[Guest yinyang]

Hi, thanks for your reply, I am still on Sertraline, I have recently increased to 200mg, so am hoping this will have some effect. I came off clomipramine as the side effects were awful and I my ocd wasn't very well controlled. Doctors have mentioned anti psychotics to me a few times, which scares the hell out of me due to the potential side effects. I'm also concerned that these aren't normal treatment for ocd, are they? x

That's OK, I appreciate it probably wasn't the answer you was looking for!

You will find quite a few people on here who take anti-psychotics, I have taken them in the past.

Like you say some of them do come with side effects so it might be worth doing some homework, it's your body so it's your choice :original:

[taurean]

I am ok with Citalopram at 20mg - the side effects were short-term but it doesn't docanything for md shdn my anxiety is very high - I have to use CBT to get that back down.

But the meds ought to, for me, be seen as an aid to assist with CBT. Anything more is good but it really is all about CBT.

[taurean]

My psychiatrist wanted me on fluoxetine but the side effects were too great.

Edited January 6, 2016 by taurean

[Tez]

Hello Lotty and All

I would like to tell you about my medication. Apols to people who have already read my previous posts on this subject as I do tend to repeat myself. I have seen several psychiatrists, and I have been pronounced as having "severe" OCD. However, I have never really had systematic CBT, cognitive therapy or any talking intervention, so I believe that diagnosis might be slightly premature. Truly treatment refractory OCD can only be diagnosed when several courses of CBT have been exhausted plus several medication regimens. And even then, there is still hope, as you can get brain surgery for really severe OCD, so there's always hope. ALWAYS. That's my mantra.

I take 40 mg of citalopram and 10mg of olanzapine. It is of great help. I do still struggle, and that's why these forums are such a lifeline. But my moods are so much better than before, as is my ability to cope with obsessive symptoms. I am a firm believer in medication, but as Taurean says, it is better if it goes hand in hand with talking therapies. CBT primarily (although some other talking therapy can help people with difficult types of OCD).

Does this help?

Tez

[PolarBear]

I wonder why such high doses are required for ocd?

It depends on what drug you are on. Generally speaking, doctors and psychiatrists prescribe higher doses for OCD than they do for general anxiety. For Sertraline the upper limit is around 200mg per day. I'm on Cipralex at 30mg a day, which is about the maximum dose for that drug here in Canada. I believe in the UK the max dose for Cipralex is 20 mg. So you can't go by how many milligrams of a drug you are taking.

[PolarBear]

Hi, thanks for your reply, I am still on Sertraline, I have recently increased to 200mg, so am hoping this will have some effect. I came off clomipramine as the side effects were awful and I my ocd wasn't very well controlled. Doctors have mentioned anti psychotics to me a few times, which scares the hell out of me due to the potential side effects. I'm also concerned that these aren't normal treatment for ocd, are they? x

Quite a few people are on anti-psychotics along with an SSRI for OCD. Don't let the name anti-psychotic scare you. SSRIs regulate the amount of serotonin in the brain, while anti-psychotics regulate dopamine and some other neurotransmitters.

There are side effects with any drug. Know what you're taking and making an informed decision.

[Guest Lotty]

Thank you all, that's helpful. Tez, how do you find the side effects on Olanzapine? Anti depressants have been a life saver for me, even though my dose has gone up and up! It would be wonderful to come off and cope with cbt alone, but I think I need that extra 'help' so that I can apply therapy techniques. x

[SnookerTable]

Doctors have mentioned anti psychotics to me a few times, which scares the hell out of me due to the potential side effects.

Anti-psychotics are also given to people with purely anxiety disorders like ocd, so please do not be afraid as I was before taking this type of medication, it has really helped me a great deal in reducing thoughts and there severity etc, and I would highly recommend you talk to your Doctor about taking this type of medication, and also people like us with ocd are generally put on much smaller doses

Again we all react differently to medication, but I was on an anti-psychotic called olanzapine for two years and it worked extremely well and no side effects except large weight gain which I believe is fairly common with this drug, so as of today have stopped taking olanzapine and am now taking a different anti-psychotic called aripiprozole with the least weight gain and maybe even no weight gain, and have taken it for nearly 24 hours with no signs of any side effects which I think would have probably happened by now if there were any, remember all drugs have side effects and companies mainly cover them selves legally for any possible side effect, please talk to your Doctor about taking a suitable anti-psychotic for yourself, there are several to choose from, but regarding weight gain the above information I have given is generally correct but again we all react differently so the side effects and amount of any side effect may be different for you, thats why we all need to talk it through with our Doctors :original:

Edited January 7, 2016 by SnookerTable

[Guest Lotty]

Thanks Snooker, I hope your new anti psychotic works as well as the previous email one but with less side effects :-) it's something I will definitely consider x

[Handy]

The reason you have to take more is your body builds up a tolerance to a drug. Its just like with heroin or cocaine. Of course there are ex exceptions but this is what every book I saw on ocd says.

[snowbear]

The reason you have to take more is your body builds up a tolerance to a drug. Its just like with heroin or cocaine. Of course there are ex exceptions but this is what every book I saw on ocd says.

I don't know what books you've been reading Handy, but you are misinformed. It's nothing like the tolerance developed on heroin or cocaine that determines the higher dose of OCD drugs. If it was they would be effective at a very low dose to start and need to be increased over time. But that is almost the opposite of what works for OCD. Typically they have to be taken at 'higher' doses from the start to achieve any effect. So that disproves your 'addiction' theory.

Either you've misunderstood what you read or the book was wrong.

[Caramoole]

I am ok with Citalopram at 20mg - the side effects were short-term but it doesn't docanything for md shdn my anxiety is very high - I have to use CBT to get that back down

.

I'm a bit puzzled Roy If the medication hasn't helped with the OCD or the anxiety why it's continued to be prescribed or why you've chosen to continue with it. How's it helping?

[taurean]

It took a long time to acclimatise to the drug after two failed attempts to do so on SSRIs previously.Having achieved that it would be a big big decision to then take on the process of gradual withdrawal.

After further thought,it IS beneficial - aiding me to engage with therapy and boosting mood - when I am able to get my high anxiety down.

I know I cannot tolerate fluoxetine so my best approach seems to be working a process of sensible but not to much ERP, non-avoidance, keeping busy, helping others, focusing in the present in the moment and maintaining the beneficial practice of nice tv, calming and enjoyable books, relaxing music and meditation in the evenings.

The key focus for me seems to be how I address a blip - thanks to the great advice from my wonderful forum friends I am doing better at easing away from the hidden compulsions that were keeping the adverse issues going.

I wondered about trying an anti-psychotic with the citalopram - its an option but I will carry on as posted above.

The medication is scheduled for review in the summer anyway.

[Caramoole]

it would be a big big decision to then take on the process of gradual withdrawal.

If it's helping you fair enough, I just wondered

Re the withdrawal, if you did decide they weren't effective it's not really a good reason for staying on them. At the moment you've not taken them long-term, you might find it more difficult five years on but with a tapered withdrawal you might not find it too bad.