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My husband has had OCD since childhood with health anxiety traits for around 5 years. He has recently had a relapse and is looking at starting to take medication but is experiencing a lot of anxiety around starting these given the list of side effects. What are peoples experiences of taking sertraline or fluoxetine? Have people experienced many side effects and have they helped reduce the number with intrusive thoughts they experience?

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Hi Emma :) 

Has your husband had any cbt for his ocd?   That would generally be the first port of call and is the gold standard as treatment. Are you in the UK? 

Medication can help some people and not others. It is different for everyone. I've had quite a positive experience with fluoxetine. I know others haven't had such a good experience. 

Have you or your husband read any self help books such as break free from ocd? :) 

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He has went through 2 years of exposure based OCD which really helped but is falling back into old habits. We are waiting for a referral back to the service but waited around a year last time till he got an appointment. Hes never tried any form of medication as hes not keen on taking tablets but has more recently considered trying it to help support him a bit more in getting better.

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I don't personally take either of those particular meds however I have heard good things about sertraline in regards to helping with OCD. Hopefully some of the other members will be able to offer their opinions on them.

In regards to side effects, I know they can sound scary but often you have to consider whether the possibility of feeling better outweighs the risks of the possible side effects. I guess it's a trial and error thing as each individual will react differently. 

Sometimes medication can help to ease the anxiety enough to help you engage in therapy, so in that context it can be helpful ?

 

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At the OCD-UK conference a week last Saturday I spoke to a few people as I was thinking of switching med to Sertraline. 

Fluoxetine and Sertraline were highly valued. Both doctors I have consulted favoured Sertraline for OCD. 

Another forum member has told me Setraline had a very supportive effect. 

So I am going through the process of giving Sertraline a try. 

What any med may actually do for anyone is subjective, individuals do respond differently. 

My doctors seem to think I will be OK with Sertraline. In general side effects may be shortlived, but I couldn't tolerate Fluoxetine side effects even beyond four weeks though many can and acclimatise OK - including my own sister. 

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Hi @EmmaG84, welcome to the forums and thanks to doing work to support your husband, us OCD sufferers definitely appreciate the effort that our families and friends put in to helping us through the battle though we may not always express it, so cheers to you, your husband is a lucky man to have you in his life :)
 

On the question of medications, I'll start by echoing what has been mentioned a few other times, medication for OCD affects each person differently, so I can't guarantee your husbands experiences will be the same as mine.  That said, I have used fluoxetine in the past for a little over a decade and for me it was a big help in handling my OCD.  Side effect wise the main one I noticed was some general drowsiness, though as I was a teenager at the time with a busy schedule and a tendency to not get enough sleep some days I am not sure the extent to which the drugs played a part.  I also had some of what now seems to be called "restless leg syndrome".  Basically I would habitually bounce my leg (usually my right) when I was sitting somewhere for awhile.  Again not 100% sure its related, but it seems to have reduced after I switched medications so possibly?  Either way neither was debilitating and definitely both were WAAAAAAY better than the pain and suffering the OCD causes, so for me at least medication was a definitely on the plus side of things.

On the question of side effects in general, it can be scary to read the whole list, but just because something is on the list doesn't mean its likely.  Many, if not most side effects are rare, they are listed out of an extreme abundance of caution rather than a measure of expected risk.  Hopefully your husband will be able to experience mostly the benefits of medication with few/no side effects if he decides to take that option.

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I am happy with sertraline. I was also very hesitant to take medication because of side effects and just general aversion to meds. Anyhow what I did that helped me was took it extremely slowly. I even got it in liquid form so I could just try a tiny bit to start and then worked very slowly up. Taking it slow just really helped me with the anxiety around taking meds.

I've been on it a few years now and maybe had some weight gain but other than that it's been really helpful. That is great if your husband already has a good understanding of CBT--i did as well when i started on the meds and it seemed to just give me the strength i needed to do the work.

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2 hours ago, leif said:

maybe had some weight gain

Oh yeah, forgot about this one.  Then again I went from being a year round athlete in high school to a 30-something IT worker with a terrible diet who doesn't get enough exercise sooooo not sure I can blame the OCD meds for that one ?

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20 hours ago, dksea said:

Oh yeah, forgot about this one.  Then again I went from being a year round athlete in high school to a 30-something IT worker with a terrible diet who doesn't get enough exercise sooooo not sure I can blame the OCD meds for that one ?

Lol! always blame the meds :)

 

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22 hours ago, dksea said:

Oh yeah, forgot about this one.  Then again I went from being a year round athlete in high school to a 30-something IT worker with a terrible diet who doesn't get enough exercise sooooo not sure I can blame the OCD meds for that one ?

Certain medications like allergy meds cause a higher appetite.  So it appears people are gaining weight from the meds but it’s just an appetite increase. 

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10 minutes ago, Handy said:

Certain medications like allergy meds cause a higher appetite.  So it appears people are gaining weight from the meds but it’s just an appetite increase. 

We aren't talking about allergy meds, we are talking about OCD meds, and weight gain is a well known possible side effect of those medications.

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2 hours ago, dksea said:

We aren't talking about allergy meds, we are talking about OCD meds, and weight gain is a well known possible side effect of those medications.

Mirtazapine, the antidepressant medication that I take, is notorious for causing weight-gain. Several studies have been conducted to establish whether the weight-gain is a consequence of increased appetite, or whether the medication slows metabolism. Because I was very conscious of the potential for weight-gain (I’m a bodybuilder, so becoming fat isn’t an option) I was extremely careful not to capitulate to the hunger pangs. And I didn’t get fatter. Mirtazapine has been a Godsend for me. I would urge everyone not to be dissuaded from trying any potentially beneficial medication because of a fear of side-effects.

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23 hours ago, dksea said:

We aren't talking about allergy meds, we are talking about OCD meds, and weight gain is a well known possible side effect of those medications.

The question is why people gain weight. A person can’t gain 10lbs by taking 5 gr pills at a time  

There is also the possibility that after a few months the meds become the compulsion.  Because they keep the person from facing their anxiety  & they need to feel it to resolve it. Compulsions keep people from doing that .

 

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16 minutes ago, Handy said:

The question is why people gain weight. A person can’t gain 10lbs by taking 5 gr pills at a time  

No but they can gain weight if the pills affect metabolism or other aspects of the bodies processes.  Weight gain is specifically listed as a side effect of OCD medication.  The OP question was about experience with medication and its side effects.  That is what was addressed.  
 

18 minutes ago, Handy said:

There is also the possibility that after a few months the meds become the compulsion.  Because they keep the person from facing their anxiety  & they need to feel it to resolve it. Compulsions keep people from doing that .

Or, you know, the medication helps people.  Please stop peddling this medication as a compulsion garbage, there is no evidence to suggest that medication use is a compulsion or that it slows or prevents recovery, quite the opposite in fact.  Medication alone is as effective as CBT alone according to clinical data, and CBT PLUS medication is more effective in studies than either alone.  Whether or not an individual feels comfortable and/or needs to take medication is and should be up to them.  But scaring them away by falsely labeling medication as a compulsion is irresponsible.  You are almost certainly NOT qualified to make that kind of declaration.

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10 hours ago, dksea said:

Or, you know, the medication helps people.  Please stop peddling this medication as a compulsion garbage, there is no evidence to suggest that medication use is a compulsion or that it slows or prevents recovery, quite the opposite in fact.  Medication alone is as effective as CBT alone according to clinical data, and CBT PLUS medication is more effective in studies than either alone.  Whether or not an individual feels comfortable and/or needs to take medication is and should be up to them.  But scaring them away by falsely labeling medication as a compulsion is irresponsible.  You are almost certainly NOT qualified to make that kind of declaration.

I 100% agree with this! I consider the medication to be absolutely vital in my treatment. It's taken a long time to find the right one, and I'm absolutely willing to take it for the rest of my life if that's what's needed. If my body didn't handle insulin properly, I'd take the medication for that without question. I consider it the same for OCD - if my brain doesn't deal with it's serotonin very well, there's treatment available for that too should I want to use it. There's no shame in taking the medication, and I don't consider it a compulsion. Sure, I feel like I need to take it, but in the same way I need to brush my teeth to avoid cavities, rather than the way OCD needs me to keep checking things! 

I understand it's not everyone's favoured approach, however, and totally respect that. I just don't know that it's helpful to compare it to a compulsion, as dksea said. 

In terms of medication experience, I've had a lot of positive gain from taking Sertraline. I was on both Sertraline and Mirtazapine for a long time, but it was the Sertraline that really changed things for me. Like the others have said, it affects people differently but I noticed a huge improvement in my intrusive thoughts on Sertraline. To me it feels like the thoughts become a little more disconnected from the anxious reaction, or muted. It gives me a little bit of room to put into practise what I'm learning in CBT when I wouldn't have been able to engage positively before. 

The only suggestion I have is to take sertraline in the morning. It made getting to sleep difficult if I took it later in the day and a doctor recommended switching times instead. Made a big difference!

I think just be honest with your doctor about any concerns. Sometimes they can prescribe other medications too that'll mitigate that - Omeprazole for heartburn/indigestion related issues, for example. ? I like to read everything on a medication leaflet but I try to remember that they have to list potential side effects, no matter how small the risk. It doesn't mean it's going to happen to me. A good doctor will be able to help find the right medication to suit your needs. And often, the side effects are temporary and wear off once you adjust to the medication, I think - for me, the benefits far out weigh the side effects.

Again though, everyone's different and has a different view. But that's my two pence worth! 

Good luck, I hope all goes well!

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I completely agree with Ivybasil and Dksea. I don’t take any of those meds but am considering changing to sertraline. I honestly don’t get why people are so against taking meds – of course therapy is also needed. If people are sick, they take medication for it – OCD is a disease as well, and some people cannot cope with just therapy, they need medication to function well. I have it since I can remember – my oldest memory is about my ocd – so it’s too far gone to be reversed with just therapy, as much as I would like it. Saying stuff like that about medication just makes ocd, depression and anxiety even more taboo and taken less seriously by other people. It’s a disease as much as diabetes or hypertension, or whatever. I’m sorry this isn’t really about the topic in question, but it’s something that really makes me mad. My mother was very apprehensive when I was told I needed to take medication, basically for my whole life, as in her mind my ocd would be fixed with just a couple of therapy sessions, as she didn't really understand the disease. I think because it’s not a visible wound and sometimes people can keep their rituals secret from their families or it’s just regarded as a quirk, as a personality trait, it’s not taken seriously. As I said, I don't take any of those meds, I take paroxetine and the side effects, at first, were awful. From most of the testimonies I’ve read, of various medications, people may have a few side effects in the first week or so, but eventually everything will go back to normal, although everyone reacts differently.

Edited by VNDO
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