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28 Year Old With OCD. On Fluvoxin CR. Mild Symptoms Still Persist. Advice On Stopping Medication?

Posted on Wed, 13 Jun 2012

Question: hello doctor
I am suffering from OCD. I got it at the age of 18.I started treatment after around 2 years i.e in 2003. Doctor started medication with Fluvoxin ( 50mg-100mg-150mg-200 mg-250mg). After that he started tapering down. Due to frequent location change I couldn't consult the same doc but all of them advised to stick with Fluvoxin. Then Last year Dr. B.K XXXXXXX advised to switch to Fluvoxin CR. Currently I am taking Fluvoxin 50 mg and facing no problem.Although still I feel repelled to dirt or some 'bad things' want to stop medication. Kindly advise me.

Answered by Dr. Ashish Mittal (6 hours later)

Hello,

Thanks for your query.

Important aspects of your query are:
•     28 year old male
•     Total illness duration 10 years
•     Known case of OCD
•     Improvement with Fluvoxin, Current dose 50 mg per day
•     Total treatment duration 8 years
•     Remaining symptom: feel repelled to dirt or some 'bad things'
•     Concern related to stoppage of medicine

OCD is chronic illness and its natural course of illness there is variation in symptom severity over a period. Like a patient who is suffering from hypertension (BP controlled with medicines) if stop medicine his blood pressure will increase again in most of cases or may remain same in few cases. Same is true for OCD.

Regarding your case I would advise to continue medicine because of following reasons:
•     You are doing well with very less dose: 50 mg per day. If symptoms reappear after stoppage of drug then you may require higher doses in future. Some time drug stopped working in such cases.
•     It is very easy to take once a day formulation.
•     You are still having some symptoms like: feel repelled to dirt or some 'bad things'. So chances are high for exacerbation of ocd symptoms after stoppage of medicine.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Ashish Mittal (11 hours later)

Hello disorder,

The pill has its side effects. It causes Excess sleepiness and also metabolic disorders.
I have read that Cognitive behavioral Therapy is helpful. Also that Treatment through Hypnotism might be helpful. I have consulted to a reputed clinical Psychologist, but it was not much helpful.Kindly advise me on that too.(I am currently staying at Dhanbad, Jharkhand. Tell me about the reputed Psychiatrist and Clinical psychologist in the region, If you have information about that.)

Answered by Dr. Ashish Mittal (12 hours later)

Hello,
Thanks for the follow up.

Yes it causes excess sleepiness but most of the patient develop tolerance for this. Each side effect is not apparent in every patient. Apart from that every drug has side effects but while using we have to do risk benefit analysis. If benefit is more than risk than it is better to continue.

Hypnosis is effective theoritically, but practically I have not seen improvement in OCD (Cognitive behavioral therapy) is best but problem is availability of therapist. For CBT you can visit following places according to your convenience:
- NIMHANS, Bangalore
- CIP ( Central Institute of Psychiatry), Ranchi
- CMC, Vellore

Wish you good health,
Regards

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Radhika