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After years on 10mg paroxetine, I slowly reduced and came off week before Christmas.  Was ok for few weeks then felt so bad tempered and depressed. Have read it can just be withdrawal symptoms but doc often puts people back on them saying depression has not gone.  How can you tell?  Is paroxtine still considered good for ocd?

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Hi Tia, 

My depression was not caused by outside influences, but from the severe periods of an episode of OCD, therefore secondary depression consequent upon the OCD. 

I know nothing about paroxetine, or if it's an SSRI, but I have been taking 20mg of SSRI Citalopram for about 4 years and it has helped me by, I think, smoothing out mood swings thus helping me ultimately to apply CBT and other psychological aids (The Four Steps, mindfulness and love kindness meditation), such that for me I have had a really good last two years. 

I plan to look to at least reduce the dose of the Citalopram in a structured way shortly. Don't think I am planning to come right off it in one leap as that may not work out too well. 

Just thought I would give you some feedback of where I am with the med, and what I am planning. 

Meds are notoriously difficult to call in OCD with different experiences from different meds. 

Was your depression secondary or primary, and are you keeping busy and happy in general now? 

Edited by taurean

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12 hours ago, tia said:

After years on 10mg paroxetine, I slowly reduced and came off week before Christmas.  Was ok for few weeks then felt so bad tempered and depressed. Have read it can just be withdrawal symptoms but doc often puts people back on them saying depression has not gone.  How can you tell?  Is paroxtine still considered good for ocd?

Hi @tia, Sorry to hear you are having a rough time.  Its certainly possible that you are experiencing withdrawal symptoms, as our bodies adjust to the different levels of serotonin, etc. it can impact our mood.  However there is not really a clear cut way to tell, these kind of decisons/diagnosis often rely on best guess and previous experience.  What you do next depends on what your goals are and how much you feel the current symptoms are tolerable or interfering with your life.  One option is to keep waiting and see what happens.  If its withdrawal it should fade in time as your body adjusts to the new normal.  If things continue or get worse its probably not withdrawal but the return of your OCD, etc.  Your best source for information on this is almost certainly going to be your doctor.  They can base their decision not just on your reactions now, but your reactions over time as well as their experience working with other patients in similar situations.  I think that talking to your doctor would be a good idea, even if you end up deciding to wait it out a little longer.  It will help you get some perspective and then you and they can be on the same page moving forward.

That said, I would be doubtful it is withdrawal related.  10mg is the lowest standard dosage level for Paroxetine and you said that you slowly reduced from that level.  But, as you said you have been on it for a long time, so perhaps your body does need a little more time to adjust.

I can understand the desire to not continue taking medication on a daily basis, its one more thing to worry about, one more piece to add to the puzzle that is your life.  If you can live happily without it, more the better!  However, if you are having a particular difficult time, well, medications role is to help alleviate that suffering and we are lucky to live in a time where there are various good options for OCD treatment and support.  It may not be what you had initially hoped for but if the medication is effective and the side effects are minimal/non-existant, continuing the medication might not be a bad idea after all.

I hope you are able to sort it out and get to a place where you are feeling better soon!

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Thank you for posting, I really appreciate it.  Want to give up. Partner said awful things for years and doc said he would try and destroy me and I must not let him.First year was happy and had baby, then he homed in on me and made life hell.  Have not cooked for 30 years we eat out, no not expensive places. but he made it impossible.  Worn out. Meant to  be moving but how can i start to cook when worried about crumbs on outside marg tub and evertything. He caused ocd to get very bad and when I started to get better would demolish me.  Said he like to hurt and torment me made him feel better.Want to be better but feel too late.Horrible to be like this. Start cbt in 10 weeks again.doc said I could go back on 10mg but that was weeks ago, as I have left it since week before christmas is that too low dose to start again.

 

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Fluoxetine (trade name 'Prozac')
Fluvoxamine (trade name 'Faverin')
Sertraline (trade name 'Lustral')
Paroxetine (trade name 'Seroxat')
Citalopram (trade name 'Cipramil')
Escitalopram (‘Cipralex’)


Healthcare professionals sometimes also refer to SSRIs as “anti-depressants” as they are also
often used successfully in treating depression. This can be confusing especially if you are not
experiencing any depression.

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11 hours ago, Handy said:

Fluoxetine (trade name 'Prozac')
Fluvoxamine (trade name 'Faverin')
Sertraline (trade name 'Lustral')
Paroxetine (trade name 'Seroxat')
Citalopram (trade name 'Cipramil')
Escitalopram (‘Cipralex’)

Keep in mind those aren't the only trade names of some of those drugs.  Trade names can differ between manufacturer and country.  
For example in the US the most common/only trade names for these drugs:

Fluoxetine - Prozac
Fluvoxamine - Luvox
Sertraline - Zoloft
Paroxetine - Paxil
Citalopram - Celexa
Escitalopram - Lexapro

 

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Medication puts the brain anxiety center into sleep so if you don’t take it the ocd comes back. You’ll feel anxiety again. 

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51 minutes ago, Handy said:

Medication puts the brain anxiety center into sleep so if you don’t take it the ocd comes back. You’ll feel anxiety again. 


This is true for some of us (myself included) but there are also people for whom medication is a temporary option while they utilize CBT to help alleviate the anxiety of OCD.  

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On 09/04/2019 at 17:57, dksea said:


This is true for some of us (myself included) but there are also people for whom medication is a temporary option while they utilize CBT to help alleviate the anxiety of OCD.  

Yes, SSRIs are meant to be a temp thing because of the side effects.

'"We now have unequivocal evidence from a wide range of side
effects that Prozac-type drugs impair the normal functioning of the brain," Glenmullen says.
He found reports of tics and other neurological side effects, like drug-induced Parkinsonism,
associated with SSRIs. "The tics include lip smacking, lip puckering, fishlike kissing motions,
and pelvic thrusting," Glenmullen says. "They are involuntary, disfiguring, and can be very
noticeable--and may persist long after the drug is stopped. This is the dread side effect in
psychiatry, and it can indicate brain damage. Such reactions are not rare. Neurologic agitation is
estimated to occur in 10 to 25 percent of patients, and muscle spasms in 10 percent."  harvardmagazine

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No, SSRIs are not meant as a temporary thing. I don't know where you get this stuff from. 

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3 hours ago, Handy said:

Yes, SSRIs are meant to be a temp thing because of the side effects.

Nope, wrong.  I’ve taken SSRIs for over 25 years now.  The only side effect has been dramatic reduction of my OCD.  Do some people suffer side effects? I’m sure they do, but even the quote you pulled indicates it’s not even most people who are effected the way you claim.  BTW, my grandfather actually had Parkinsons, I’m well aware of what that looks like and I can assure you I don’t have anything like that.  I’ll happily keep taking my SSRIs and my psychiatrists have been happy to prescribe them.  I’m going to go with my doctors and the knowledge and advice of multiple national mental health organizations on this one.

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Fine then you take the risks. 

 

MYTH: Once on antidepressants, I’ll be on them for life.

FACT: Not true. A general rule clinicians often use is that a person should be treated with antidepressants at least one-and-a-half times as long as the duration of the depressive episode 

Edited by Handy

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1 hour ago, Handy said:

Fine then you take the risks. 

ALL medical treatment involves taking risks.  One of the roles of doctors is to help monitor and inform the patient of those risks and weigh them against the benefits.  The risks and benefits of SSRI's were explained to my parents and myself by my doctor when I first started taking them and as I continue to take medication I make sure to have an open and honest dialog with my doctor about how am I doing and we keep an eye on any tests for signs of trouble.  25 years in the benefits have FAR outweighed the initial risks and given my response to SSRI's and lack of noticeable side effects its perfectly logical to continue.  Thats responsible medicine.  In contrast, what you are doing, spreading inaccurate information and making unsubstantiated claims about treatment meant to scare people is irresponsible.  For example:
 

1 hour ago, Handy said:

MYTH: Once on antidepressants, I’ll be on them for life.

FACT: Not true. A general rule clinicians often use is that a person should be treated with antidepressants at least one-and-a-half times as long as the duration of the depressive episode 

Neither myself nor anyone else on this forum is making the claim that once on anti-depressants a person MUST remain on them for life.  NO ONE.  We have said, accurately, that SOME people use SSRI's long term, some use them short term, and some not at all.

Next, you make a claim about a "general rule".  Where is your source?  What medical policy or medical guidance do you have to back up this claim?

Finally, OCD is NOT DEPRESSION.  A person with OCD may ALSO suffer from clinical depression, but they are NOT the same thing.  So even IF your claim is true for Depression it wouldn't apply to OCD.  You treat each condition as appropriate for that condition.

Many members of this forum have different experiences with and opinions on whether medication is helpful for them in treatment or not, and thats fine.  But it is not helpful to make blanket assertions, particularly when they are innacurate. 

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I know OCD is not clinical depression but where did I say OCD is clinical depression dksea?

 

There are a lot of people on medications in the forum & if they took their own advice they wouldn't need the medication.  

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17 hours ago, Handy said:

I know OCD is not clinical depression but where did I say OCD is clinical depression dksea?

Um, you said it right here:

On 12/04/2019 at 09:32, Handy said:

FACT: Not true. A general rule clinicians often use is that a person should be treated with antidepressants at least one-and-a-half times as long as the duration of the depressive episode 



Meanwhile:

17 hours ago, Handy said:

There are a lot of people on medications in the forum & if they took their own advice they wouldn't need the medication.

Again, you are wrong.  You have absolutely no idea what each persons individual situation entails.  You have no idea what medical decisions they and their doctor have made.  If you don't need medication, congratulations.  Telling others they don't need medication is irresponsible, you are not their doctor, you should not be acting like one.

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On 12/04/2019 at 08:40, Handy said:

I know OCD is not clinical depression but where did I say OCD is clinical depression dksea?

 

There are a lot of people on medications in the forum & if they took their own advice they wouldn't need the medication.  

That is so not accurate. It is incredibly difficult for sufferers of severe or extreme OCD to fully overcome their disorder without a helping med hand. Some do it, but it's really hard. 

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On 13/04/2019 at 10:14, PolarBear said:

That is so not accurate. It is incredibly difficult for sufferers of severe or extreme OCD to fully overcome their disorder without a helping med hand. Some do it, but it's really hard. 

But that’s the point too- medication doesn’t cure OCD. It can make some people feel better, yes.  One must also account for that placebo effect too & for SSRIs it’s pretty high.  In other words they take medication & feel better about the same percentage as if they took a sugar pill. In those that felt better the advantages over placebo were slight.  This is all public information one doesn’t have to be a doctor to find it. 

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A general approach to meds in OCD seems to take the view that meds act as "water wings" to help the sufferer stay afloat and feel able to engage with CBT. 

But for some sufferers reporting in here, the meds have achieved much more than that and, with CBT alongside, have made a significant improvement when the CBT on its own had not. 

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41 minutes ago, Handy said:

But that’s the point too- medication doesn’t cure OCD.

You are making a straw man argument, setting up a point no one is making to try and argue against it.  None of us here have suggested that medication will cure OCD.  (In fact, currently there is no medically recognized cure for OCD, even CBT isn't truly a cure).  We are simply offering support for a fellow sufferer who is facing a difficult time with one aspect of dealing with their OCD.  Sometimes thats therapy related, sometimes its medication related.  Both of which are evidence supported, medically recommended, OCD-UK recognized, ways of dealing with OCD.  The reality is some of us need medication to help live our lives, some of us don't.  Just like many medical conditions the specific details of treatment vary from person to person based on circumstances, such as strength of illness, medical history, drug allergies, other conditions, etc.  If you have been/are able to achieve your treatment goals towards OCD without the need for medication thats great for you.  Don't assume everyone is like you, don't assume there situation is exactly like yours.  Show some respect for the fact that others paths to wellness aren't going to look exactly identical to your own and there is nothing wrong with that.

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2 hours ago, Handy said:

But that’s the point too- medication doesn’t cure OCD. It can make some people feel better, yes.  One must also account for that placebo effect too & for SSRIs it’s pretty high.  In other words they take medication & feel better about the same percentage as if they took a sugar pill. In those that felt better the advantages over placebo were slight.  This is all public information one doesn’t have to be a doctor to find it. 

No one has said meds cure OCD. I find your comment about the placebo effect in people with OCD to be highly suspect.

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