Suggest better medications for anxiety, negative thoughts and OCD

Posted on Wed, 10 Jun 2015 in General Health
Question: Respected Sir,
Patient is suffering with anxiety, negative thoughts and OCD i.e. continuously looking at the door repeatedly and checking whether it is close or not, having fear from crowd, etc.
She is 45 years of age and suffering since last 5 years.
Initially nexito- 20 mg along with sizdon- 1mg per day was taken on the advice of doctor for 2 years and situation has improved but not cured fully. Medicine was discontinued and the situation became poor gradually in 3 years.
Last 3 months nexito - 10 mg along with sizdon - 0.5 mg per day was taken and situation improved to some extent.
Doctor has advised to take only nexito 20 mg per day since last 10 days, but the condition is not satisfactorily improving.
Kindly advice a permanent and complete cure.
Answered by Dr. Shubham Mehta 50 minutes later
Brief Answer:
Nexito (escitalopram) is not approved for OCD.

Detailed Answer:
Welcome to HCM.

OCD co-morbid with depression is difficult to treat.
OCD is a chronic, relapsing disorder and 100% cure is very difficult.
The patient has to take drugs regularly to keep his/her symptoms under control.

Another important thing in treatment of OCD is that Nexito (escitalopram) is not approved by FDA for OCD treatment.

In my opinion, the better choice is fluoxetine (max dose-120mg) or sertraline(max dose-200mg).
She should be started with single drug (either fluoxetine or sertrailne) with low dose and dose can be increased gradually depending on the response.

Also, as he condition is not improving with nexito, this also an indication for change of drug.

If she does not respond to the single drug, the augmenting drug of choice should be clomipramine and not sizodon (its an antipsychotic).
Sizodon is a third-line agent in OCD or it is used if psychotic symptoms are present.

Kindly discuss these issues with her doctor. Please do note that all the drugs mentioned above are prescription drugs.

Hope this helps.

Feel free to ask further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Shubham Mehta


Practicing since :2008

Answered : 2004 Questions


The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions
Drug/Medication ,   ,  
Medical Topics ,  

Recent questions on  Clomipramine

doctor1 MD

Is Elavil a narcotic? Daughter has addiction to Xanax, hydrocodone, under Dr. care for this and starting Suboxone about one month...

doctor1 MD

Can gabapentin show up as methadone on a drug test?

doctor1 MD

I have OCD , ADHD , anixiety, and a lot of the time I have no interest in anything and feel tired all day long what is this from

doctor1 MD

I m 32 years old. During sex my sperm release is within two minutes. Please advise what can i do.

doctor1 MD

Hello...I have been on Anafranil for years for racing and intrusive thoughts. It has really helped me with symptoms more than any other drug. But...

doctor1 MD

I have been taking Clomipramine for OCD for years, as well as Xanax for anxiety and Triazolam for insomnia. In the last year, the obsessive rituals...

doctor1 MD

I'm having severe anxiety attacks. I get heart palpitations, I sweat, I even shake sometimes. Is there anything that I can take for this? I already...

Get personalised answers from verified doctor in minutes across 80+ specialties

183 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction