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Dr. Andrew Rynne

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Exp 50 years

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How can I manage sexual impulses and impulsive thoughts when diagnosed with anxiety and OCD?

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Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 2998 Questions

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Posted on 3 days ago in Mental Health
Question: I am diagnosed with anxiety, spectrum and OCD. I get unwanted thoughts and my brain is not free. I get impulse to behave violently, impulse to act sexually. My mind is not free and peaceful. I am suffering from this torture. I am unable to sleep peacefully also.Please help me


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I am taking quetiapine 25mg and the response is fine. I am getting 3-4 hours sleep when I take it.

Fluvoxin 100mg 2-----X------2
Venlafaxine 150mg 1-----X------1
Ativan 2 mg 4-----X------4
Quitipin 25mg X-----X------1

The response has been slow.


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Thanks for the reply. Please mention the dosage of Clomipramine that I should start with and what time I should take it.
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Answered by Dr. Ashok Kumar 22 minutes later
Brief Answer:
Please mention the dosage of the medications.

Detailed Answer:

Hi,

First of all, I like to know the response of quetiapine which I recommended a few weeks back.

In addition, it is also important to mention the dosage of each medication you are currently using and duration of use.

I also like to know the response till date so I can answer you conclusively.

Let me know if I can assist you further.

Regards,
Dr. Ashok Kumar, Psychiatrist



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Brief Answer:
Follow up

Detailed Answer:

Hi,

Considering your diagnosis of OCD and impulsive thoughts and sexual impulses, my thinking forces me to believe that Venlafaxine is not a suited medication. In my opinion, clomipramine should be part of treatment rather than venlafaxine. This is because venlafaxine has no or little role in the treatment of OCD but clomipramine is well suited for this purpose. The dose of clomipramine is 75-300 mg per day which can be build up slowly over a period of time. I am quite hopeful that this particular medication will able to control your thoughts to the optimum level.

I also feel that quetiapine can be increased to 50 mg per day as this augments the action of fluvoxin and other antidepressants in addition to having a good night sleep

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Ashok Kumar, Psychiatrist


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Brief Answer:
It is started with 25 mg under the guidance of a doctor

Detailed Answer:

Hi,

The decision to start or not to start should be approved by your treating doctor as every medication needs supervision of a doctor. However, in my patients, I often start 25 mg per day at bedtime and depending on the tolerability and response increase 25 mg every one to two weeks.

I hope this answers you further.

Regards,
Dr. Ashok Kumar, Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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