Wednesday, December 19, 2007
OCD treatment, psychiatrist's thoughts
OCD is often not treated aggressively enough. If you are being treated for OCD, expect to be prescribed high doses of SSRI"S (PROZAC, LUVOX, ZOLOFT, PAXIL, CELEXA AND LEXAPRO). Though benefits are seen as early as 3-4 weeks, maximal benefit is seen at the 3rd month. if all is better, consider backing off to a typical dose after 6 months. This maintenance dose should continue for three years. After three years 1/3 of OCD patients can actually be cured. It's not always this easy, however. If OCD and bipolar coexist it makes it much harder to treat because SSRI's make bipolar balance worse, in that case, medications like Neurontin can be helpful. Don't overlook the benefits of the vitamin B Inositol, I've seen it work.
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2 comments:
I had a breakdown with my OCD in Sep of 2006. I was always reluctant to take meds. However, I went on 15mgs of Lexapro per day and it worked wonders. I know it is a low dose for OCD treatment as a typical dose of Lexapro can go up to 20mgs per day. I stayed on that for about a year and dropped down to about 10mgs per day. I think the Lexapro still works but to a lesser extent. As such, I have a couple of questions. 1) Did I start off on too low a dose? 2) Should I increase my dose or stay at the same level for another 3 years as you suggest?
My OCD still waxes and wanes even with medication, i.e. things can get real bad still while other days are great, is this consistent with your treatment of those that have OCD? Or do they usually have the symptoms completely or almost cured? Thanks very much.
My philosophy has always been less is better. The lower the dose, the better since all medications are foreign to the body and may produce more side effects at higher doses.
OCD usually waxes and wanes with stress. The more stress the more OCD symptoms return. Psychotherapy can help give you strategies to manage the more difficult times.
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