Monday, 11 August 2014 4 comments

OCD medications

Largely over the years, my experience with medication for OCD has been centred around SSRI's (selective serotonin re-uptake inhibitors). In the scheme of mental health medication, these are relatively new medicines but have become widely used from everything from depression to eating disorders.

Over the years I have taken the following (some names might be UK only or brands, I'm not sure) -

Paroxetine (Paxil, Seroxat)
Citalopram (Cipramil, Celexa)
Escitalopram (Lexapro, Cipralex)
Fluoxetine (Prozac)
Sertraline (Zoloft, Lustral)

Tricyclic antidepressant
Clomipramine (anafranil)

Of all of these medications, in terms of impact on OCD, I think I found Clomipramine the best. However, the side effects made it counter-productive. I was getting a very dry mouth, tiredness, sweating ridiculously, trouble sleeping and absolutely no sex drive.

With paroxetine and Citalopram I couldn't stop my legs bouncing when sitting down. I think it's called something like restless leg syndrome or something. I kind of had this anyway due to anxiety but the bouncing of my legs was worse and was fuelling anxiety. In fact I think Citalopram heightened my anxiety more than anything else I've tried. That's when a change came and I was offered Escitalopram.

Escitalopram was the medication I was on the longest. It solved the problems I had with Citalopram and was reasonably effective. It came about that I had to stop taking this though as it was not getting approval from the medical community in the UK. It was proving dangerous for certain patients and some research had linked it to heart problems and some other stuff, but this was mostly in older patients. A decision was taken by various medical boards that it shouldn't be prescribed any more. It sounds like these doctors were being overly cautious, but my doctor was getting flack for prescribing it to me on an on-going basis despite the latest denouncing of the drug.

Fluoxetine was useless. It made no difference to me whatsoever. I was on 20mg, then 40mg, then 60mg and it was like I wasn't on any medication at all. Absolutely no impact. I tell you what, that was a hard few months going through the dosage changes and waiting for improvement. They say 4-6 weeks for every new medication or dosage increase. Working through different medications is a difficult thing. Not only can it increase the very symptoms you are trying to get rid of, but because you also know that you can't expect any improvement for the next several weeks, you end up wondering how on earth you are going to get through it? Today is too long for me to endure, never mind 6 weeks!!

Sertraline is my current SSRI and I have to say I am rather pleased with it. I have some side effects like almost falling asleep every afternoon while at work, but I try to fix this by standing up and having a walk around the office for a few minutes to wake up. I also sweat quite a bit more than normal (hyperhidrosis), but that's the worst of the side effects. Sertraline has not removed my thoughts, as I think they are quite normal thoughts anyway, but they help reduce the anxiety that normally accompanies them.

I have a level of anxiety all of the time and the sertraline doesn't remove that, but it's managed to the level that I can be functioning with the anxiety, even use it occasionally to my advantage. My mind still races and I can either zone in on a specific topic intensely or be jumping around frantically, but the sertraline seems to be preventing any debilitating bouts of anxiety, fear and any all-consuming compulsions.

Sometimes I think that if people knew what I was thinking, they'd truly believe I was insane. Especially when medication does not eradicate the whole problem.

The purpose of this post is not to dissuade anyone from trying these medications. I don't want anyone going to their doctor and saying "LDSruminations says Prozac is awful, so I won't take it".

This post is more about saying that if you try a medication and it doesn't work, there are other options. In fact Prozac might be the very one for you. While it didn't work for me it works for many other people. I have just found that some were better than others for me.

I was once close to being prescribed an anti-psychotic as well, but that scared me a bit and I told the doctor just to leave me on SSRIs. Just the name of that type of drug scares me. I went down the route of believing I was schizophrenic at the mere suggestion. That caused several weeks of anxiety and checking medical sources for symptoms that matched mine.

There are medical options out there, and it is very wise to consult professionals about them. As long as it doesn't exacerbate your condition, doing your own research is helpful too. It was my own research that led to the diagnosis of OCD in the first place.

I had no clue about OCD until I googled my thoughts. What a mind bending trip I was put on when my compulsion to check the internet and medical symptoms actually yielded some beneficial fruit. I was astounded that I was reading exactly how I felt. I wasn't trying to make it fit, it just did.

Reading and knowledge can be your friend in the right circumstances.

If you are on or considering medication, it is my belief that it is a worthwhile course of action. I don't know if I will ever be off medication again, as I've proven to relapse very badly when I'm off medication but I am losing my pride in this instance and submitting to the prospect I may need them long-term.