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What Causes Persistent Active Thoughts Of Hurting Oneself And Others?

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Posted on Wed, 8 Jun 2016
Question: hello-
i have been sturgglling for 10 years with urges that are violent images and thoughts that are related to harm. I have been on alot of different ssris that have not controlled the symptoms. I always think im gonna get a gun or shoot someone or myself. I do not want to do any of this but the thoughts seem to be out of my control. I currently take anafranil risperadal and klonopin are these what you recommend and what does the diagnosis sound like
doctor
Answered by Dr. Alexander H. Sheppe (2 hours later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

First, before we discuss medications, if you are having active thoughts of hurting yourself or others, you need to visit an emergency room for an immediate evaluation by a trained professional.

This sounds like OCD to me. Treatment of OCD consists of using a high-dose SSRI, or if this fails as it seems is true in your case, using a tricyclic antidepressant. You are currently taking Anafranil, which is an excellent tricyclic antidepressant used for OCD. If you are on the maximum dose (250mg), I would consider switching to a different tricyclic such as nortriptyline, but first the Anafranil dose needs to be maximized.

Please remember to rate and close this answer when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Alexander H. Sheppe (2 days later)
my doctor took me off the anafranil because he cant go any higher my blood level was too high. so hes going to try another medication what others are used i think he said remeron is one of them
doctor
Answered by Dr. Alexander H. Sheppe (34 minutes later)
Brief Answer:
Followup

Detailed Answer:
There are dozens of medications that could be used so I won't list them here, but Remeron would be a perfectly acceptable medication to try for your condition.

Please remember to rate and close this answer when you are finished and satisfied.

Regards
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Deepak
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Answered by
Dr.
Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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What Causes Persistent Active Thoughts Of Hurting Oneself And Others?

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. First, before we discuss medications, if you are having active thoughts of hurting yourself or others, you need to visit an emergency room for an immediate evaluation by a trained professional. This sounds like OCD to me. Treatment of OCD consists of using a high-dose SSRI, or if this fails as it seems is true in your case, using a tricyclic antidepressant. You are currently taking Anafranil, which is an excellent tricyclic antidepressant used for OCD. If you are on the maximum dose (250mg), I would consider switching to a different tricyclic such as nortriptyline, but first the Anafranil dose needs to be maximized. Please remember to rate and close this answer when you are finished and satisfied. In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers