Posted by phidippus on November 3, 2012, at 21:35:32
In reply to OCD, posted by brynb on November 3, 2012, at 20:38:54
>I think I have OCD and it's progressively getting worse...negative loops and dark thoughts over and over again, and more...
If you are having intrusive thoughts that are becoming recurrent you could be experiencing OCD.
>What med have you found to be the most helpful for it?
I have found Clomipramine, Mirtazapine, Viibryd, Abilify and Keppra to be the most helpful medications I've used to treat my OCD.
OCD involves a defecit of serotonin, a surplus of dopamine and noradrenaline in the brain. First line of treatment for OCD is a high dose antidepressant-those recommended by the American Psychiatric Association are SSRIs, Effexor, Mirtazapine and Clomipramine (which is considered the gold standard for OCD). If one experiences only some response with an antidepressant, augmentation with an atypical antipsychotic is recommended. If that still doesn't do the trick, augmentation with a glutamate antagonist is recommended-Topomax and Lyrica are examples of glutamate antagonists.
You're currently taking 20 mg of Lexapro. A dose of 40 mg would be sufficient to treat OCD.
If you're having OCD symptoms despite the Lexapro, I would recommend trying another SSRI-Luvox might be a good choice.
You said 'and more'. What more is there?
Eric
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DSM IV Obsessive Compulsive Disorder (OCD) CriteriaA. Either obsessions or compulsions:
Obsessions as defined by (1), (2), (3), and (4):
(1) recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress
(2) the thoughts, impulses, or images are not simply excessive worries about real-life problems
(3) the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
(4) the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)
Compulsions as defined by (1) and (2):
(1) repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
(2) the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
B. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.
C. The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the persons normal routine, occupational (or academic) functioning, or usual social activities or relationships.
D. I another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g., preoccupation with food in the presence of an Eating Disorder; hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation with drugs in the presence of a Substance Use Disorder; preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder).
E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
http://www.cnsforum.com/imagebank/section/neurochemical_pathways_OCD/default.aspx
Eric
poster:phidippus
thread:1030493
URL: http://www.dr-bob.org/babble/20121029/msgs/1030618.html