Debate: Meds, CBT, Other Or A Combination?

[taurean]

For me, the fact that meds are very individually subjective, don't work for many and may present at least an initial challenge on side effects stands against them.

Also they can take a long time before they may work, and a long time to come off.

And when they are beneficial, how much again seems very variable.

CBT has a great track record, but many fail to follow its doctrines.

I have found it, plus REDS (relaxation exercise diet sleep) mindfulness and guided meditation a good combination, and am hoping Citalopram may aid smoothing out peaks and troughs.

[PolarBear]

I don't think anything stands against meds. They either work well or they don't. In the mean time, every effort should be expended on CBT with an emphasis on ERP.

[taurean]

I had two bad experiences with meds when I was working.

Citalopram seemed to cause constant diarrhoea.

I tried fluoxetine (prozac) and it made me very tired plus diarrhoea.

Having retired, I elected to try meds again. I chose the Citalopram after asking the forum members for their input. And I was given a med to address the diarrhoea when needed.

The diarrhoea soon stopped, and I found I had to get my overall excessive anxiety levels down first - working really hard at CBT - then after two months the med kicked in.

If at first you don't succeed, try again is my thinking on this from my experience.

Some have found that adding an anti-psychotic drug makes a big difference - so maybe worth exploring if an SSRI alone is not making a difference.

Once I got comfortable on the meds, the biggest difference I found was that I became able to engage with ERP.

Edited July 4, 2015 by taurean

[Guest joe_123]

I'm really not sure whether the fluxotine is helping for me. I'm on about my 7 week of 20mg/day. I have managed to stop some rituals, but I think they were the easy ones and also talking stuff over with the therapist seems to give me a bit of a push.

I am fairly tired on them, I only manage 4-5 hours sleep a night (although I've never been a good sleeper) and I have moderate diarrhoea. I have almost zero ability to concentrate (even before the medication). Should fluxotine 20mg have any effect on OCD?

One thing I find is I'm a bit of an emotional rollercoaster on the medication. Yesterday in work I was feeling angry/resentment towards everyone and didn't speak to anyone. Then a colleguage started to chat with me and I started to feel really negative about myself and started crying. Then half an hour later I started feeling really anxious and just wanted to get away from everything.

Before this it was just ocd and anxiety but now every thought and thing that happens is like being hit by an emotional brick.

[taurean]

My psychiatrist told me I needed to get up to 40mg at least on fluoexetine for it to have an effect on my OCD, but I couldn't get there - on 20mg diarrhoea was extreme and I was tired all the time plus my anxiety symptoms stayed really bad. But she really wanted me to try and stick with it - she was confident if I could get to 40mg and habituate so the side effects ceased (they often seem from what people say to usually do so).

I didn't manage to stay on them, but the fluoxetine has really helped my sister who is able to take 60mg. She found it reduced intrusions and helped her to cope,and with no side effects.

You may need to report back to your doctor - but it can take a long time to habituate/start feeling benefit.

I am doing ok on the Citalopram - I couldn't cope with that either when I first tried it, but I stuck at it second attempt.

[Guest joe_123]

I'm due to run out in 2 weeks so I will be seeing my GP again for a review. The first week I had the tiredness very bad, it's not as bad now but I have a lot of trouble getting a healthy amount of sleep. The diarrhoea has only been for about 10 days, but now it seems to be stopping a bit. I had a period when my Gastroesophageal reflux flared up and I was barely keeping any food down.

I'm feeling a lot more emotional than I have in years, but I think that's more due to discussing my problems and the amount of focus they have had the last few weeks when dealing with the OCD.

It's good you are doing ok on citalopram, I feel I've got a bit of work infront of me but the best I can do is keep trying.

[ACE]

Yeah I think it's hard to say there are that many meds out there so it's really sort of impossible for us to have tried them all & know whether they really are benefi cialfor us or not.In saying that I do understand people's thoughts on meds in general.Personally I've felt being on the right meds has really helped me to tackle everything else in my life properly& as better as ever really :original: .