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March 11, 2013 at 1:13 pm #3195OCDdocMember
Hello Dr Jenike
Firstly i cant praise you folks enough for running this online help service..Im a doctor myself and can understand the effort required to run such a service amidst your busy professional life.
Im a Psychiatry CT-2 trainee and have suffered from Severe Pure O ocd for the last 10 years..Fluoxetine,Escitalopram,Sertraline all worked when i started them but pooped out after 3,4 weeks every time..An increase in dose makes it work again but this too loses effect in a couple of weeks time..Which is very strange as patients on SSRIs generally seem to get better with time.
I have also tried Paroxetine,Clomipramine,adjunct olanzapine,Aripiprazole,Topiramate with little success…Nothing worked except for Topiramate(as adjunct to an SSRI) which caused my obsessions to tone down but triggered a relapse of Depression 2 weeks into the trial.Right now im on a combination of 200 mg Sertraline and 20 mg Escitalopram.I know guidelines dont support SSRI co-therapy but it does seem to have an added on benefit in my case.
I went through CBT sessions as well a year back and they didnt help at all.
Im beyond miserable right now with severe Ocd and secondary depression..It seems like the only option left is SNRIs though they dont have as much of a robust data in OCD as the SSRIS.
Would you recommend giving Venlafaxine/Duloxetine a trial?..and as monotherapy or adjunct to SSRIs?.
Thank you so much.April 3, 2013 at 6:58 am #3302Barbara RosembergKeymaster
Thank you for your post OCDdoc. My apologies for the delay in the response. Dr. Jenike is currently traveling so there might be a delay in his reply to you.
BarbaraApril 3, 2013 at 3:49 pm #3305Dr. Michael JenikeMember
yes, i would try the other drugs, but during all drug trials you should be seriously doing CBT. it seems like you discount it, but it really is the best treatment for OCD and will make drug treatments work better. however, you have to do what is asked of you. perhaps your CBT therapist is not too experienced with OCD. you can go to http://www.ocfoundation.org and click on the globe and put in your location and therapists will come up. let me know if i can help further. all best wishes,
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