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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Joe Rogan on September 30, 2014, at 17:28:44
I was suggesting Luvox or some augmentation but he says Desipramine has effects all the way up to 300MG (I'm only on 50). The reason I am concerned is because OCD is really crippling my life. I can kind of notice beneficial effects at 50MG but I am still crippled by anxiety, compulsions, and behavioral patterns. HE also says Zyprexa works for OCD too (so I always take it). If I stop taking Depakote without taper I get a LOT of noise in my head which NEVER use to be a problem until in 2010 I went off it cold turkey and I think it damaged my brain. I also take Adderall XR @ 30MG but I have tolerance, and he says the highest he will go is 40MG.
Posted by Joe Rogan on September 30, 2014, at 17:34:46
In reply to My doctor says Desipramine can fix OCD?, posted by Joe Rogan on September 30, 2014, at 17:28:44
The intrusive thoughts are sexual and violent. The doctor told me ADHD and OCD go hand and hand together. I confirmed this by internet research, apparently 40% of people with ADHD have OCD. How do I get rid of this problem? Will increasing Desipramine handle this disease of disordered thought and compulsion ?
Posted by SLS on September 30, 2014, at 21:20:58
In reply to Re: My doctor says Desipramine can fix OCD?, posted by Joe Rogan on September 30, 2014, at 17:34:46
> The intrusive thoughts are sexual and violent. The doctor told me ADHD and OCD go hand and hand together. I confirmed this by internet research, apparently 40% of people with ADHD have OCD. How do I get rid of this problem? Will increasing Desipramine handle this disease of disordered thought and compulsion ?
I would think that clomipramine (Anafranil) would be a better choice for the OCD. Desipramine is a metabolite of clomipramine. If there is any residual ADHD, you could look at adding a stimulant.
- Scott
Posted by Phillipa on September 30, 2014, at 21:57:02
In reply to Re: My doctor says Desipramine can fix OCD? » Joe Rogan, posted by SLS on September 30, 2014, at 21:20:58
Or Luvox but might have to lower other med doseages as luvox can potentiate the effects of certain other medication and caffeine. Phillipa
Posted by Phillipa on September 30, 2014, at 22:05:00
In reply to Re: My doctor says Desipramine can fix OCD?, posted by Phillipa on September 30, 2014, at 21:57:02
Psych Central has an interesting article on adhd and OCD and in my own experience I agree. Phillipa
http://psychcentral.com/lib/ocd-and-adhd-is-there-a-connection/0009772
Posted by ed_uk2010 on October 1, 2014, at 14:54:35
In reply to My doctor says Desipramine can fix OCD?, posted by Joe Rogan on September 30, 2014, at 17:28:44
Desipramine is certainly an unusual choice. It is a selective norepinephrine reuptake inhibiting tricyclic. Desipramine is generally thought to have no efficacy in OCD, either alone, or as an 'add on'. It can however, improve certain ADHD symptoms, as well as some symptoms of depression.
OCD is generally treated with a moderate-high dose of an SSRI, or alternatively the tricyclic clomipramine (Anafranil). Clomipramine has a very potent action on serotonin, which desipramine completely lacks. Other meds such as antipsychotics (eg. Zyprexa) can occasionally be of use as an 'add on' in OCD but are not usually the primary treatment.
Sertraline (Zoloft) might be a suitable SSRI if you've not tried it before because it is well established in OCD, and has minimal drug interactions with your other meds. Sertraline may raise your blood level of desipramine slightly but this ought not to be a problem on your current dose.
An SSRI (fluvoxamine), but not the SNRI desipramine, proves useful in OCD...
http://www.ncbi.nlm.nih.gov/pubmed/2112374
Sertraline is useful in OCD patients who also suffer from depression. Desipramine is not so helpful here....
http://www.ncbi.nlm.nih.gov/pubmed/10632236
Desipramine does not improve the response to SSRIs in OCD...
http://www.ncbi.nlm.nih.gov/pubmed/9286191
Hope this helps.
Posted by Christ_empowered on October 2, 2014, at 22:05:28
In reply to Re: My doctor says Desipramine can fix OCD? » Joe Rogan, posted by ed_uk2010 on October 1, 2014, at 14:54:35
A lot of shrinks don't read the literature. They come to their own conclusions based on experience, personal preferences, etc. Psychiatry isn't science, its...I don't know...sort of like modern day witch doctoring a lot of the time.
Luvox is fairly standard for OCD, although any SRI will do. As ed pointed out, the doses for OCD are often higher than the doses for depression and anxiety. Higher doses also run the risk of flattening, hypofrontality, sexual dysfunction, and apathy.
That said...I'd rather be on something that has data behind it than some magical cocktail whipped up my a modern day alchemist, lol. Anafranil can be rough stuff, but its more effective than a lot of other options.
The trick, I suppose, would be to get the OCD under control while minimizing meds and side effects, drug acquisition costs, etc.
can you do any kind of therapy? Have you tried non-drug stuff, like inositol, niacinamide, etc. ?
Good luck!
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