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Suggest Treatment For Obsessive Compulsive Disorder

Posted on Sat, 5 Apr 2014

Question: I have pure O OCD, and I have been on Cymbalta 120 mg for 4 weeks. (I started at 60 mg about 8 weeks ago. I also take 2mg of risperidone at night. I recently had a death in my family and my Obsessive thoughts are coming very frequently. I am getting scared that no medicine will work for me. Am I giving the medicines enough time to work? I am so scared that the thoughts about my own death will never end. It is so frightening seeing myself in a coffin. I am trying cognitive behavioral therapy by XXXXXXX Schwartz, but the thoughts don't diminish. What should I tell my Psychiatrist?

Answered by Dr. Srikanth Reddy (38 minutes later)

Brief Answer: Its natural with the OCD treatment Detailed Answer: Hello, Thanks for choosing health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. Its very natural during the usual course of treatment of OCD. There are only 3-4 medicines that work properly by OCD. If the medicine work well and fine but if it doesnt work then the medicine is changed. Stressors does increase the OCD symptoms and it is very natural. Further the increase in symptoms is temporary. Your psychiatrist has started you on cymbalta which is not a first line treatment of OCD. Dont know why? But still cymbalta is effective in certain cases. Even if it doesnt work then there are still first line options for OCD available like fluoxetine, fluovoxamine, clomipramine, sertraline etc. All these medicines are very effective and need to be tried before you feel that the drugs are not useful for you. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: bit.ly/dr-srikanth-reddy Wish you good health, Kind regards Dr. Srikanth Reddy M.D.

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

Follow up: Dr. Srikanth Reddy (2 hours later)

What is the best medicine for OCD? What about Anafranil? Can it be used with cymbalta? I was on Prozac and it worked well for a long time. Could I start taking it again even though it stopped working over 16 years ago? I am getting desperate.

Answered by Dr. Srikanth Reddy (1 hour later)

Brief Answer: The order of effectiveness Detailed Answer: Hello The evidence has shown that the order of effectiveness for the drugs are: Fluoxetine < Escitalopram < fluvoxamine < Clomipramine (anafranil). You may try these options one after the other. Fluoxetine may also be tried even though it had stopped working. Many times it may start working the next time. Regards Dr. Srikanth Reddy MD

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

Follow up: Dr. Srikanth Reddy (11 hours later)

Which medicine has helped your patients the most? Is Anafranil better than prozac? I really need to get better and want to know if I should have more relief from Cymbalta at this point? I see my pdoc on Tuesday and want to know what I should tell her.

Answered by Dr. Srikanth Reddy (8 hours later)

Brief Answer: The combination is very effective Detailed Answer: Hello In rotine practice I have noted tht prozac and anafranil are almost equally ettective. Some may benefit with the first option where as some with the second. Infact its the combination of both of them with behavioural therapy that is the most effective. Not much experience with cymbalta as not a single book suggests it as a good drug for ocd. You may discuss with your p doc to switch the medicine and start you on prozac or anafranil and in future if necessary the combination. Regards Dr. Srikanth Reddy MD

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