Brief Answer:
it is likely Obsessive Compulsive Disorder (OCD)

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us. I can understand your concern.

You have anxiety problem. Unwanted intrusive thoughts, words and acts suggest possibility of Obsessive Compulsive Disorder (OCD). Social anxiety can be part of OCD or individual disorder. Both are treatable conditions.

For your information I am writing diagnostic criteria of OCD here.

A. Presence of obsessions, compulsions, or both:
Obsessions are defined by and :

- Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.

- The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).

Compulsions are defined by and :

- Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g.,praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.

- The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.


B. The obsessions or compulsions are time-consuming (e.g., take more than hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

To confirm diagnosis detail history should be evaluated and mental status examination should be done by a psychiatrist in person.

If you feel you have chances of OCD, please consult psychiatrist for treatment.

In general treatment of OCD (as well as anxiety disorder) includes medicines and psychotherapy.

SSRI group of drugs (fluoxetine,paroxetine,sertraline, escitalopram) are main stay of the treatment. They are antidepressant and in OCD used in high dose.

Benzodiazepines group of drugs (clonazepam, lorazepam or etizolam) are used initially for short duration for fast symptomatic relief.

Cognitive behavior therapy (CBT) is also very useful. It is a type of psychotherapy.

In moderate to severe cases initially medicines and then CBT is added.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

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Brief Answer:
fluvoxamine is drug for OCD

Detailed Answer:
Hi,

Thanks for information and sorry for delayed response. Fluvoxamine is an SSRI drug and used specifically for OCD. It is recommended up to 300 mg dose. In general treatment of OCD should be taken for at least 6 months. Initial improvement was likely due to clonazepam. There is need of increasing the dose of fluvoxamine. Please discuss with tour doctor and continue the treatment.

Feel free to discuss further.

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