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Suggest Treatment For OCD, Major Depressive Disorder And Brain Fog
Question: Hello Dr., I have been suffering with anxiety issues for a number of years now and about 4 and a half years ago I was hospitalised with severe OCD (intrusive thoughts) which were debilitating and was prescribed Anafranil (Clomipramine) and Seroquel to relieve the OCD. Prior to this I suffered a manic episode which I believe resulted from the medication I had been prescribed by my GP for my depression (Paroxetine) and was subsequently treated with a number of different drugs which ultimately proved ineffective. The new doctor, who has since prescribed Anafranil and Seroquel, has been treating me for the OCD and major depressive disorder, and I have recovered significantly from the OCD and has assisted me in my part-time university studies. However, I find that many days I simply feel lethargic, depressed and don't feel like doing simple things as they seem to be much more difficult, and I am often irritable and become stressed easily. When I breach the subject with the Dr, and ask about whether additional medications or treatments can be added (i.e. an antidepressant to combat the lack of energy), he simply says that the treatment has been good for me and is unwilling to alter the medication. Right now, I am finding it difficult to cope with the simplest tasks and I think that I would benefit from additional antidepressant medication, because I am suffering this "brain fog" each day and am not coping very well. I don't know what to do, as I want to remain on the current medication as well, so I am reluctant to seek another psychiatrist's opinion considering the dreadful experience I had with the first doctor. Please advise me on what steps I may need to take and the questions I should ask. What kinds of treatments could be available in my situation? My family members are straight out opposed to ECT treatment, and I am afraid of having to undergo a general anesthetic as I have previously had a bad reaction to an inhalation anesthetic, with severe emergence agitation and a horrendous feeling of being suffocated by the foul-smelling gas. Please advise me on your opinions and options for me. How can I ensure I get the most appropriate treatment? Thank you for your advice.
Brief Answer:
Other treatment options for OCD are available
Detailed Answer:
Hello welcome to HCM
OCD is a type of anxiety disorder and is a disorder which is difficult to treat. In a lot of individuals the disorder is found co- morbid with depression.
You have been on Paroxetine for depressive symptoms and the developed manias. Paroxetine is known to cause manic switch in a lot of individuals. Now you are on Clomipramine and Quetiapine for OCD and depression. Both of these drugs are good drugs for OCD and depression. Now your OC symptoms are under control but some symptoms like lethargy, brain fog are persisting. For the symptoms you are having there is need to add some other drug.
Modafinil can prove good option for your symptoms as the drug helps to reduce symptoms like lethargy, drowsiness and brain fog. The drug helps in better functioning in depressive patients.
Other options you can go for is non medicinal therapies like ECT, brain stimulation methods etc. You don't want ECT because of anaesthesia, so other methods like RTMS (recurrent trans cranial magnetic stimulation) can be used. The process is non invasive method and have equal efficacy to medicines in resistant depression.
Cognitive Behaviour Therapy or CBT is also other option.
You can discuss with your psychiatrist for these treatment modalities for your symptoms.
Hope this helps you, please ask again if you have more doubts.
thanks
Other treatment options for OCD are available
Detailed Answer:
Hello welcome to HCM
OCD is a type of anxiety disorder and is a disorder which is difficult to treat. In a lot of individuals the disorder is found co- morbid with depression.
You have been on Paroxetine for depressive symptoms and the developed manias. Paroxetine is known to cause manic switch in a lot of individuals. Now you are on Clomipramine and Quetiapine for OCD and depression. Both of these drugs are good drugs for OCD and depression. Now your OC symptoms are under control but some symptoms like lethargy, brain fog are persisting. For the symptoms you are having there is need to add some other drug.
Modafinil can prove good option for your symptoms as the drug helps to reduce symptoms like lethargy, drowsiness and brain fog. The drug helps in better functioning in depressive patients.
Other options you can go for is non medicinal therapies like ECT, brain stimulation methods etc. You don't want ECT because of anaesthesia, so other methods like RTMS (recurrent trans cranial magnetic stimulation) can be used. The process is non invasive method and have equal efficacy to medicines in resistant depression.
Cognitive Behaviour Therapy or CBT is also other option.
You can discuss with your psychiatrist for these treatment modalities for your symptoms.
Hope this helps you, please ask again if you have more doubts.
thanks
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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