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emmiew

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  1. Just to give an update. A family member has helped us with the money to go and have a consultation with a psychiatrist privately. My partner will have an hour long review of all medication options. It is very possible that the advice given will be the same but it will be very useful to have a second opinion. Having worked for many years myself with people with MH ( I am an SEN teacher and have taught students with dual diagnosis of MH and LD) It has always been standard practise I have observed that a new medication would be reviewed before giving another new medication on top of that one. The review with the private psychiatrist will enable the olanzapine to be reviewed as well as hopefully exploring all medication options . I still find it concerning that in primary MH care there does not now appear to be an entitlement to see a psychiatrist until it goes to secondary care. My partner never actually met the psychiatrist that reccomended his medication change a year ago. Anyway, I will post how we get on. My partner is reducing his fluoxetine in readiness for a potential change. He is in a terrible state of anxiety poor thing.
  2. OCD like behaviours can increase with weight loss as the brain loses mass which has behavioural changes. I would concentrate on supporting weight restoration as best you can.
  3. I wonder if she has an eating disorder? It might be worth looking at the charity BEAT and its resources.
  4. For me its just really tough not having my partner and my sons father there for us. Its really tough. Its scary wondering if he will ever get better and wondering if its better not staying with him for me and my son. I want someone to give me hope he might get well again. Hes got so so much worse. I too feel like I wouldn't know where to start in terms of finding someone to talk to about it. I am so full of disappointment and resentment and frustration at his family for causing a lot of the trauma and being so uselessly in denial about how ill he is.
  5. I've just checked out the maudsley pharmacy. Brilliant! Yes, it is only for healthcare professionals but I will try phoning them and if they won't talk to me I will try going through CADAT.
  6. Hi there, thanks very much for this information. My partner is having sessions with CADAT and they advised he speak to his GP but sad if he did not get a satisfactory answer to get back to them and they would try to push for him to see a psychiatrist. In the past this has never been an issue and he has sat down and had a full consultation with a psychiatrist during treatment. Our son has been having therapy from the maudsley also for an eating disorder and he has a psychiatrist who actually gave us some advice today re medication protocols ( off the record) and is concerned that my partner is not getting proper advice. Its a shame really because I think with the right medication then the therapy works more efficiently in my experience and then less of it is required. I'm really concerned that my partner seems to be needing more and more medication to be well. I am wondering if olanzapine is acting as a depressant in his case as well as I have heard that this can be the case. I am going to check out the maudsley pharmacy now. Sounds like it exactly what we need. Thanks again.
  7. Ok. Thanks snowbear. I do appreciate what you are saying. I can see that with the anxiety levels he has already that if he were anticipating it would be difficult then of course this would not help. It would be really useful to know if generally it was expected that making a transition like this may have consequences we can mitigate against. For example loss of sleep, worsening of mood. In my view if he does not have these then I'm not sure what the point of taking the current medication would be in the first place but I guess there is the half life to consider and how long like you say the meds stays in his system. Taking a pragmatic approach we have decided he reduces from 60mg fluoxetine to 40mg to see how this is. We are going to try and get more advice and also look at times when work is less challenging to make further changes if he decides to go ahead. Thanks for your help
  8. https://www.sps.nhs.uk/articles/how-do-you-switch-between-tricyclic-ssri-and-related-antidepressants/
  9. Thanks for the response. Although I am an advocate of positive thinking and agree with your comments to a degree,I also like to have an evidence base behind important decisions like this. It concerns me that my partner has not yet been given the opportunity to address these questions to a psychiatrist. There are protocols around switching from one medication to another and these appear to exist ( in my opinion) because there are risks to changing medication. For example in one pharmacy wesbite I looked at it was saying that in cases where there is severe depression it is inadvisable to switch medications slowly and that cross tapering could be considered. I will continue trying to learn more before supporting my partner to make this important decision. If he loses his job this has a huge impact on our family. It is not a decision to approach with blind faith in an inexperienced GP who should have referred my partner to a psychiatrist and not just looked info up on a table online.
  10. Thanks Jamie. I have only just noticed that you moved it here. Well today I'm back again. My partner is in the middle of his therapy sessions with the maudsley. So far no change in his mood which continues to be very low and his OCD themes are as strong as ever. My partner has just had an appointment on the phone with the GP after waiting 3-4 weeks and was advised a protocol to go on to clomipramine he takes 60mg fluoxetine and 7.5mg olanzapine The protocol is reduce fluoxetine to 40mg for 2 weeks reduce fluoxetine to 20mg for 2 weeks stop talking fluoxetine completely for 2 weeks start taking clomipramine at lowest dose and build up after 2 weeks This potentially means 8 weeks at least of being destabilised by a medication change. my partner has a responsible job and this could be extremely tough.It could potentially also make the therapy even less effective. Has anyone else changed from fluoxetine/olanzapine to clomipramine and did they follow a similiar protocol?
  11. Do you have physical symptoms of IBS or is it fear that you will or a mix of the two?
  12. Hi, I have just joined OCD UK. I have been with my partner for 21 years and we have a 13 year old son together. We are both in our 50's. My partner has struggled with OCD since he was in his teens. His OCD was triggered in all likelihood from the trauma of being at boarding school where he was bullied a lot. He has had various epsiodes of severe OCD since we first met which after treatment became more manageable low level OCD. In the last ten years he has been helped with fluoxetine/quetiapine and CBT/ERT at the Maudsley CADAT. During the pandemic the combination of a virus/possible covid triggering depression and general anxiety about safety led to his OCD spiralling into higher levels of anxiety, lower mood and an increase in OCD themes. He has intrusive thoughts, contamination OCD and body dysmorphia. Previously fluoxetine and sometimes the addition of quetiapine made him more receptive to therapy. He came off the quetiapine and stayed on fluoxetine. During this current severe episode which has lasted for a year already he was given an increased dose of fluoxetine i.e. 60mg and also olanzpine 7.5mg. initially the olanzapine helped him sleep and seemed to put him in a much better mood although he also became a bit high and reactive to things and would lose his temper a bit more. This lasted a couple of mnoths then he slumped in to more of a depression. He has not been able to meet with a psychiatrist at all and he was given this prescription via his GP. The psychiatrist advised that if this mix of meds did not work that he should try clomipramine. My partner has a very responsible job and is just about holding it together to do his work. He is sick of feleing so depressed and obsessed and really isn't sure his current meds are working. The GP said it wasn't worth switching from olanzapine to quetiapine as they are both anti psychotics. The advice was if its not working switch to clomipramine. I am wondering if anyone can help with our concerns which are: how would he transition from his current meds and try clomipramine? We are very concerned he could become more anxious and not be able to sleep. Would he need to take time off work? we have been given no guidance about this. Could fluoxetine/quetipaine work slightly better or are they really much of a muchness? My partner has had his third session of CBT and is starting ERT but I think as previously happened if his mood was stabilised a bit more with meds he would probably make betetr progress.
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