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Suggest Treatment For OCD Behaviour While On Deplin

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Posted on Thu, 20 Oct 2016
Question: hi Dr. Mendiratta! It was nice to hear from you again. I was giving the rexulti and deplin a chance to work before I wrote back. They have made a little difference and that has given me hope. I also ordered two homeopathetic remedies that were given great reviews along with a money back guarantee. I haven't got them yet. I was also told that I should look into CBT (cognitive behavior therapy) which I learned is not the same as group therapy that I take 3 days a week. I ordered a book this morning so that I can learn about it. As you have told me, it's more than just the meds. What are your thoughts on these things? XXXXXXX
doctor
Answered by Dr. Naval Mendiratta (2 days later)
Brief Answer:
CBT

Detailed Answer:
Dear XXXXXXX

Good to know you are feeling better. Sorry was out of country for Araynas bday and just returned...

Well, CBT you can try definitely. It is mostly used for Obsessive compulsive disorder patients, but it is known to have other uses as well. Somewhere to get the thoughts out of the mind. And since your new medicines are working, maybe an addition of behavior therapy can give a boost to it. You can gather some information from the book, but you will need a specialist to give you training on how to perform it.

Good to know things are turning good for you

Do keep in touch

REgards
Dr naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Naval Mendiratta (21 hours later)
hi doctor, and I'm glad that it was a happy birthday. The medicines are not clicking as well as I'd like yet but it will take some time. Another psychiatrist said that if rexalti doesn't work in the long run, then try the med that you suggested:duloxetine. Dr XXXXXXX showed me on my genetic testing what was wrong. If you still have access to it, it's on page 3 of 8 in the first column: Gene Result. The first one says Serotonin Transporter-high risk of nonresponse. The fifth one says Methylenetetrahydrofolate Reductase-low activity. Then you can read the Therapeutic Implications across each one. That was his basis for choosing those meds. He said that it will get better. I'll keep you posted on the book and the meds. Hope that you're feeling okay. XXXXXXX
doctor
Answered by Dr. Naval Mendiratta (22 hours later)
Brief Answer:
Genetic TEsting

Detailed Answer:
Good evenin XXXXXXX

Well, if it helps you 20 % also in the 3 weeks, that is considered a good response. It normally builds up over time and then tends to have an effect. Duloxetine was my first choice too. Even though ur genetic testing said against Serotonin transporters with risk of side effects, Duloxetine is still the drug of choice. Maybe that s why they are keeping it as the last resort incase nothing works. Yeah keep working on CBT as well. And try to forget about it. I feel you are monitoring the response very closely. It is better to just take the tablets, do some other fun activities and let the medicines take control

DO take care...and Would love if you could freak out one fine night

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta (2 days later)
hi Dr. Mendiratta---if I would freak out one night I may run my blood sugar to 500! I've never been one to just let loose and forget about everything because diabetes requires constant monitoring. That's why I've lived this long with few complications. I received my Cognitive Behavior Therapy today and I might have bitten off more than I can chew. I hope that I can understand it! Do you think that I can get something out of it? You mentioned that I monitor myself with the CFS. I've had it for so long and it's been so bad that it never leaves my mind, just like diabetes. No, I've never taken my health for granted and in a way that's a good thing. I am learning, however, to ease up a bit and to enjoy life a bit more. I'm not there yet but I'm improving. I hope that everyone is healthy. XXXXXXX
doctor
Answered by Dr. Naval Mendiratta (9 hours later)
Brief Answer:
Further Course

Detailed Answer:
Good evening XXXXXXX

Well, CBT will get better in time. It is a bit difficult to grasp initially but you may get hold of it over due course.

Yeah, that is one thing I noticed about you. There is no harm in being over cautious about your health, but somewhere your mind needs to wander free as well. Away from all the stressors. Even short breaks where mind is just relaxed do help. That is the sort of cycle we need to break through. It is always tough, but if you are able to acheive it you may not even need CBT. I do counsel my patients to indulge in some activities which are more fun sorts or whichever they like doing and the ones who manage to, achieve quicker and better results. You are motivated ok, but you on a constant look out for improvement/new symptoms/connecting previous things. That is one thing I would like you to change. Tough, but not impossible

Things are good here..

Take care

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
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Follow up: Dr. Naval Mendiratta (18 hours later)
hi Dr. Mendiratta, after reading the first chapter of the book, it doesn't appear that I will utilize much information----but I will read the whole book. I certainly have given you the wrong opinion of my brain. In group therapy we talk alot about COPING SKILLS. From 2008-2012 I drew 650 cartoons and wrote 1000 anecdotes about various things. Since then I've read 50 books, go out to eat at least once a week, take walks through this small town, call my kids, watch TV, and have gone to group therapy 3 times a week for the last 4 years. During the 2009-2012 timespan I went to a clubhouse 3 times a week and went on most of their weekend activities. During all of this time the CFS has gotten progressively worse until I could stand it no longer and had to tell my therapist over a year ago that I was sick. Have I given my brain a break? Have I done the best that I could considering the circumstances? Yep. I've just never told you about all of this because we were talking about my problem! Rest assured have spent alot of time just laying across my bed for long periods of time because I couldn't stand it any longer. That is how I've coped with this illness. When I get up I feel just as bad as when I layed down. I hope this explains the other side of me. XXXXXXX
doctor
Answered by Dr. Naval Mendiratta (3 days later)
Brief Answer:
Delayed response

Detailed Answer:
Good evening XXXXXXX

Sorry for the delayed reply. Had been caught up with a few things. Twice I started to reply back and something happened and the reply went off in between...

Well, I didnt know this side of yours...Quite a creative side with so many cartoons and anecdotes. These are the things that kept you going.

I would love if you restart on these things again. Since we have found a medicine for you and hopefully CBT, along with your cartoons and novels, would be a combined therapy which we usually recommend.

Dont stop. Keep it going

Keep in touch and let me know how things are

Take care
REgards
Dr Naval
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Naval Mendiratta (42 hours later)
hi Dr. Mendiratta, and yes, there are many things that kept me going over the past 6 or 7 years. I can't restart the cartoons and the anecdotes because I'm burnt out as you can imagine. They served a purpose and now I do other things. Yes, I am creative. I wrote an 8 hr DVD movie for my kids and built my youngest daughter a two story treehouse with a front porch and a deck in the backyard. I got most of the wood at construction sites-they are so wasteful with wood. These are some of the things that I am proud of. I even served two years as assistant Cubmaster for my son. We never talked about these things because I was trying to get well first. I never would have made it to this point if I had the CFS during all of those years. It was bad enough with depression and 30 ECT treatments. I was diagnosed in 1976, three months after I got married. I'm still reading the book and feeling just a little better each day. Hope you are OK. XXXXXXX
doctor
Answered by Dr. Naval Mendiratta (29 hours later)
Brief Answer:
Further course

Detailed Answer:
Good evening XXXXXXX

Well, Must say you make a great father and a great grandfather to be devoting so much time for your kids and grandchildren. Wish I had a grand-dad like you :)....

I am in a bit of rush today.. Gonna catch a flight soon...Will be out of town for 5 days....

I hope you will be even better when i come back and already kicking CFS out of your system....

Take care

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

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Suggest Treatment For OCD Behaviour While On Deplin

Brief Answer: CBT Detailed Answer: Dear XXXXXXX Good to know you are feeling better. Sorry was out of country for Araynas bday and just returned... Well, CBT you can try definitely. It is mostly used for Obsessive compulsive disorder patients, but it is known to have other uses as well. Somewhere to get the thoughts out of the mind. And since your new medicines are working, maybe an addition of behavior therapy can give a boost to it. You can gather some information from the book, but you will need a specialist to give you training on how to perform it. Good to know things are turning good for you Do keep in touch REgards Dr naval