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Mental Health (Expert Forum)
Best Med. for OCD ??? Need Help!
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Best Med. for OCD ??? Need Help!
by amk627, Jul 21, 2001 12:00AM
I have been suffering from OCD for at least a good 30 years.
I am 38 years old and have been picking the skin off my fingers (mostly) and sometimes my lips since I was a little girl. My father was verbally abusive and generally a tyrant. I never thought it was ocd I just thought I had a bad habit. Now that I have ezecma on my fingers, I got it in 1995 after my divorce,
the picking has gotten worse, and combined with the ezecma my hands look gross. I went to see a doctor because when I tried to stop the picking I developed anxiety. And now the anxiety is worse so my Doctor put me on Buspar. I have been taking Buspar since March, two tablets 15 mg. a day. In the beginning it seemed like it helped but I am right back to picking and having anxiety about it. I do not have panic attacks or any type of social anxiety, just high level frustration and sweats from trying to stop picking my fingers, I don't even know I am doing it.....I am at my wits ends, please help me, do I need therapy?
Is it to late for that? I also have frequent thoughts about death and dying, I fear it!!!!!! Everyday I thing about it and sometimes have scary thoughts about harm coming to my children..
whats wrong with me???? I have a wonderful husband now, I have since remarried in 2000. He is very supportive but does not understand this ocd.. To tell you the truth I don't either. Everytime I get into my car, I wonder is todaythe day I am going to die. When I hear about other people dying I have anxiety for a few days until It passes, is this part of the disorder also...?? Any help would be appreciated..Thank you.
I am 38 years old and have been picking the skin off my fingers (mostly) and sometimes my lips since I was a little girl. My father was verbally abusive and generally a tyrant. I never thought it was ocd I just thought I had a bad habit. Now that I have ezecma on my fingers, I got it in 1995 after my divorce,
the picking has gotten worse, and combined with the ezecma my hands look gross. I went to see a doctor because when I tried to stop the picking I developed anxiety. And now the anxiety is worse so my Doctor put me on Buspar. I have been taking Buspar since March, two tablets 15 mg. a day. In the beginning it seemed like it helped but I am right back to picking and having anxiety about it. I do not have panic attacks or any type of social anxiety, just high level frustration and sweats from trying to stop picking my fingers, I don't even know I am doing it.....I am at my wits ends, please help me, do I need therapy?
Is it to late for that? I also have frequent thoughts about death and dying, I fear it!!!!!! Everyday I thing about it and sometimes have scary thoughts about harm coming to my children..
whats wrong with me???? I have a wonderful husband now, I have since remarried in 2000. He is very supportive but does not understand this ocd.. To tell you the truth I don't either. Everytime I get into my car, I wonder is todaythe day I am going to die. When I hear about other people dying I have anxiety for a few days until It passes, is this part of the disorder also...?? Any help would be appreciated..Thank you.
Doctor's Answer
by Roger Gould, M.D., Jul 23, 2001 12:00AM
, Jul 23, 2001 12:00AM
I would strongly recommend that you begin therapy. You are a bright and alert woman living in a good situation but you are saddled with the remnants of your past living in your head. Therapy is the way to clear a pathway to the future. Medications can help as an adjunct.
I am not a doctor, so I don't know what constitutes OCD, or what delineates it from GAD. I am, however, a pharmacist so I can help you with the therapy. One of the first medications specifically indicated for the treatment of OCD is Luvox (a generic is now available--fluvoxamine). It is similar to other seratonin-reuptake inhibitors like Paxil and Prozac. Of course, any decision about which therapy is best should be made by you and your doctor, but if you have any other questions about the medication, I'd be happy to answer them.
John W. (R.Ph)
I have been on Ativan for just over ayear now for Anxiety (gad).
I was at a peak level of 3mg aday and am now down to 1mg aday.
I tried alot of different drugs before Ativan... Zoloft,celexa,paxil and Buspar but non seemed to work or mad me sick. Im 36 male 175 pounds and 6 feet tall. This anxiety all started after being pretty sick for about 6 weeks from food poisoning the doctors think, My drug question is I really want off Ativan but don't know what else to try any suggestions? I hear beta blockers can work too.. thanks if you reply.
greg
I will make an appointment with my doctor about an alternative medication for me instead of Buspar. I don't think this medication is working for me. I also am going to ask for a good therapist. Maybe I do need to clear out some ghosts from my past.
I did however want to say that my dermatologist prescribed Ativan for me for itching (from my ezecma)and I could not take it in conjunction with the Buspar. I did not know that Ativan was used also for anxiety. I do know they said it would make me very drowsy. Anyway, thanks again everyone, I will let you know how it goes at the doctors office. And John W. I make take you up on your offer to explain certain meds. to me when she prescribes a new one for me. Thanks for helping me out in advance.
amk627
Sorry to hear about your troubles. I should note at the outset that I think you're figuring out that these novel and very expensive medications are not working up to their promise! Accordingly, I hope you are working with a therapist to overcome your anxiety--medications can help, but they shouldn't take the place of the expertise that a qualified psychologist or psychiatrist.
Now, I'll get off my soap-box, and answer your question. First, getting off the Ativan is probably a good idea. You mentioned beta-blockers. These are a viable alternative to the benzo's because they are not habit-forming. They work by controlling the symptoms of anxiety (i.e. shortness of breath/hyperventilation, tachycardia, etc.). The medication used most often for anxiety is Propranolol. This is a non-specific beta-blocker (not targeted just for the heart muscle). I'm not too sure if this is a good route for GAD (again, it should be your MD's call). Generally, it is used for things like performance anxiety. In other words, if you are anxious because of symptoms (racing heart and S.O.B.) these might be o.k. But, if your anxiety is mental in etiology (going crazy or getting sick), the beta-blocker might not be the best.
Now, with respect to what other medications you could try, there is a fairly new medication called Effexor that you might consider. It is a seratonin AND norepinepherine reuptake inhibitor (paxil and prozac only inhibit seratonin). It also inhibits a smaller amount of dopamine. It is indicated as an adjunctive treatment for GAD (combined w/counselling). There are competing studies about which dose is appropriate, so your M.D. will have to decide. If you slowly titrate (i.e. increase) your dosage, you'll avoid many of the side-effects.
Good luck and let me know if I can help any further,
John W. (R.Ph)
I just wanted to tell you that (1) you are making the right decision about treatment, and that (2) i'd be happy to answer any questions that you have about any new medication. Just remember, that medication alone will not heal you!
I should also note in passing that I was shocked that your dermatologist prescribed Ativan for itching!!! I can only hope that (s)he prescribed a small dose (like 0.5 mg), a small amount of pills (maybe 20), and you use them on an as-needed basis (like twice a day or at bedtime). This is because this type of medication can be habit-forming and is wholly ridiculous considering the wealth of anti-histimines that are available to combat itching. These will also make you drowsy, but they won't get you hooked! Please be careful!
Let me know how your appt. goes!
John W. (R.Ph)
I mean you go to the hospital 1 day and think your dying of a heart attack, they run all these tests and say your just dehydrated from being sick and get a couple of IV's..... But as a patient you of course ask for more and they give very little. I mean you have chest pains..etc.. and you'd like to have maybe a follow up or conclusive tests done just to make sure. Emergency room testing even in a big hospital like I went to is looking for an emergency but what if it was my heart giving me a warning sign? I don't know it just seems like with todays HMO's and PPO's doctoers don't over test thats for sure.
anyway thanks for all your help and will let you know what happens.
Greg
Sorry for any confusion, thanks for all your help....
amk627
as for meds that have worked-- i have only found two and the rest have not helped at all. one is risperdal-- at a LOW dose-- and the other has been sinequan (a tri-cyclic anti-depressant). sinequan helps with anxiety and depression and somehow has helped me out of my dark world of ocd.
ocd is not GAD (generalized anxiety disorder)---
I was prescribed anafranil 200-250 mgs. It has helped me alot. I tried luvox and was burning badly in the sun. I tried a different drug