Brief Answer: Try another antidepressant Detailed Answer: Hi Thanks for using healthcare magic. I, Dr Abhishek Kapoor, would help you in this query. You have been taking citalopram for depression and anxiety for last three years and still got dermatillomania, that means drugs is not effective in controlling obsessive disorder. In case of dermatillomania and OCD, citalopram is not as effective as fluoxetine, fluvoxamine or clomipramine. All these three drugs effective in both depression as well as OCD symptoms. If you have OCD signs since childhood, then may be you have underline obsessive compulsive personality traits or disorder due to which now for last few years you got dermatillomania. In that case, fluoxetine or fluvoxamine would be more effective as it would help to control obsessive thoughts better than other drugs. If you do not get benefit from these drugs, then shift to clomipramine. You can also do psychotherapy to control these dermatillomania and OCD symptoms by doing relaxation exercise or behavior therapy. Both drugs and psychotherapy would give better result than drug alone. For sleep, you can carry on with trazodone or can take low dose benzodiazepine like clonazepam that would help to control anxiety during day time. Rest, you can discuss with your psychiatrist. In case, you need further help, you can ask. Regards Dr. Abhishek Kapoor Psychiatrist

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