Re: any med suggestions?

November 5, 2008

Hi ,

Well, with your lovely adjectives I'm not sure I can live up to all

that! But I'll give you what little I have " gleaned " from our

experiences with medication.

The somewhat unfortunate truth is that each person responds

individually to each ssri and there is no way of knowing which one,

or if any one will have a positive benefit until it is tried. The

usual approach is to try them all, giving each one 6 - 8 weeks trial

at minimum at the maximum dose. Generally it is the higher doses

that work for OCD, and it can take longer, three months for maximum

efficacy, longer than say for depression.

If none of the ssri's are helpful then usually anafranil is the next

choice. It is an older medication that can have more side effects,

interactions with other meds and usually you need to do blood tests

to test levels(I think?). The atypical anti psychotics are often

added to ssri's to boost their affects or to offset side effects.

Having said all that, our son had big problems at higher doses and is

helped at a lower dose. Often with the higher doses you can get

problematic side effects such as behavioural issues, aggression, less

inhibited etc and for this a low dose anti psychotic is often added.

We experienced all this, and were hesitant to add the second med, but

things got bad and we did, and well, things got really bad after

that. It is so individual though, some people are really helped by

one thing and combo of things and others are not. I know I'm not

being very helpful because you are probably looking for a more

specific answer, but it's not really possible.

The way it was explained to me once was that some people have one

thing that needs to be targetted and one medication will do it.

Others have multiple aspects affected and it is then a delicate

balancing act to find the right doses and combos to make things

work. Unfortunately it is all a case of trial and error, which just

stinks.

The one piece I learned after going through our difficulties is that

prozak and risperidol(anti-psychotic) can be problematic if you lack

an enzyme to metabolize them, which I believe is the case for our son

who had a big reaction to both of these. Not sure if a test exists

to check for this enzyme.

Ours takes celexa 10mg/20mg depending on the time of year, and

severity of symptoms. Usual dose would be 60mg. The adage of go

slow and stay low is a good one, so you can really see the effects.

Lastly, since medication is rarely a cure, you look for the optimal

dose that will take the edge off, assist with function, and give

least side effects. Since ERP/CBT is the only evidence based

treatment for OCD, the medication is used to turn down the intensity

of the OCD so that a person can do the ERP. Sometimes the medication

works so well that there are no symptoms to work on - we only

wish !!! In that case the dose would be reduced so there was

something to work on. Because generally the OCD will become more

severe if a person does not learn how to manage it, ie challenging

the thoughts/compulsions it is essential that this skill is learned.

I remember thinking/hoping that the medication would " fix "

everything, when the OCD was so severe. It definitely helps a lot,

reduces the intensity, but it will continue to grow itself, and can

seem to have no end. It does take time....

I do hope the next med choice works out for your daughter!

Warmly,

Barb

>

> Hi everyone, Just thinking ahead and wondering what you wonderful,

informed, intelligent and experienced OCD parents may have to share!

As I've shared with you all (ad nauseum!), we're weaning my dd off

her Zoloft and if all goes well she will be down to 25 mg in 3 weeks

when we return to her neuro. Zoloft is the only med we've tried yet.

When the neuro (and I) decided to discontinue the Zoloft, I asked her

where she thought we were heading, what the plan re: meds is, etc.

She stated quite frankly and honestly that she didn't really know yet

and we'll see when we get there. Just wondering if any of you have

had any experiences with switching from one SSRI to another, or even

specifically from Zoloft to another SSRI or even another class of

med. that you would like to share. Any feedback, successes or

failures , are welcome! THANKS!! P.S. Wondering how Kathy and her dd

are doing!! Hope they do have coffee!!

>

November 5, 2008

My daughter switched easily between SSRI's when we decided to do it to see if we

could get better results or because one seemed to exacerbate her trich. Â She is

now on Anafranil which is a tricyclic antidepressant and the first med in the US

approved to treat OCD.

any med suggestions?

Hi everyone, Just thinking ahead and wondering what you wonderful, informed,

intelligent and experienced OCD parents may have to share! As I've shared with

you all (ad nauseum!), we're weaning my dd off her Zoloft and if all goes well

she will be down to 25 mg in 3 weeks when we return to her neuro. Zoloft is the

only med we've tried yet. When the neuro (and I) decided to discontinue the

Zoloft, I asked her where she thought we were heading, what the plan re: meds

is, etc. She stated quite frankly and honestly that she didn't really know yet

and we'll see when we get there. Just wondering if any of you have had any

experiences with switching from one SSRI to another, or even specifically from

Zoloft to another SSRI or even another class of med. that you would like to

share. Any feedback, successes or failures , are welcome! THANKS!! P.S.

Wondering how Kathy and her dd are doing!! Hope they do have coffee!!

November 6, 2008

Barb, you certainly did live up to all my lovely adjectives!! I guess you summed

it all up with the words, " just stinks " . I really knew about all you so kindly

shared with me but I suppose I needed to hear it put so succinctly and

concisely. I need to address my feelings of disappointment re: the med. I know

intellectually that there is no magic bullet and that meds are so trial and

error, but in my heart, I think I was wishing we would be one of the lucky ones

who hit it right the first time. Just making the decision to medicate is so

difficult and then proceeding to give a med that may even make your child even

worse, " just stinks!!! Thanks so much for taking the time to post your