rajan1: OCD, anxiety, intrusive thoughts

[rajan1]

Dear sir/madam,

 

I'm 50. Since childhood I suffered from symptoms of ocd, axiety, intrusive thoughts. In 1987, age 20, I was diagnosed and given clomipramine after experiencing acute panic attack, since then I switched to many other trycyclics along with bezodiezepines. In 1988 I was treated with ECT as well. In 1991 I was given fluoxetine along with clomipramine and dexfenfluramine(isomeride)plus cognitive behavioural therapy(exposer therapy), for a couple of months I was also given phenelzine(Maoi) in 1996, symptoms and disturbance hardly improved, bouts of panic attack returned after every couple of years. In   1997 I was prescribed with sertraline, I must say however that since then panic attacks have hardly returned and felt life better, compulsive behaviour and anxiety subsided but intrusive thoughts remained. However I would like to admit this as a partial recovery. 20 years since I would like to wean from the medication but afraid that panic attack could return because once it happened. On the other hand I also read in the web that a refractory depression or ocd could be treated with supratherapeutic medication to bring better result, that is to say that, to add   extra or double the amount of doses than normaly recomended. I'm now on 100mg sertraline which was incleased from 50mg about a two months ago. I have also read about serteraline associated hepatotoxicity and mitochondrial impairment may play an important role in liver injury induced by sertraline. Though 20 years on sertraline I have been tested negative for all the abnormal parameters for lever function from the periodical lever function blood test. My concern is also that if I'm given a supratherapeutic medication with sertraline: say from maximum recomended dose of 200mg to gradually 400mg/day could my normal parameters for lever function go abnormal? or could there be any alternative to treat my refractory ocd? ? looking forward to have your say. Thanks for reading.

                                                                                                                                                                     

 

               

Edited October 31, 2017 by rajan1
a little bit of spelling mistakes

[MollyN]

Hi rajan1,

 

Welcome to Surviving Antidepressants (SA)! I'm glad you're here and can bring your questions to this forum.

 

Can I ask that before we go any further, you complete a 'signature'? This will be a succinct summary of the drugs you've taken and the length of time you've taken them. Your 'signature' will appear automatically below every post you make on this site and will help other people to understand your experience and background. 

 

Here is a description of how to do it and what to include:

 

Please include - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly? 

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

Thanks so much rajan1, hope to hear from you soon xxxmollyn

 

[apace41]

9 hours ago, rajan1 said:

On the other hand I also read in the web that a refractory depression or ocd could be treated with supratherapeutic medication to bring better result, that is to say that, to add   extra or double the amount of doses than normaly recomended. I'm now on 100mg sertraline which was incleased from 50mg about a two months ago. I have also read about serteraline associated hepatotoxicity and mitochondrial impairment may play an important role in liver injury induced by sertraline. Though 20 years on sertraline I have been tested negative for all the abnormal parameters for lever function from the periodical lever function blood test. My concern is also that if I'm given a supratherapeutic medication with sertraline: say from maximum recomended dose of 200mg to gradually 400mg/day could my normal parameters for lever function go abnormal? or could there be any alternative to treat my refractory ocd?

 

Rajan,

 

Welcome to SA.  First things first, we are not a medical website so it would be dangerous for any of us to comment on the possibility of liver malfunction should you greatly increase your dose of Sertraline as a means of attempting to treat what you are calling "refractory" depression and ocd. Nobody can predict that even though your tests to date have been fine and, as you obviously are aware, it is a danger.  Second things second, we are a website dedicated to helping people safely taper off medication so that is our first goal.  We are never going to be the ones that are supportive of taking a "supratherapeutic" dose of medications that we are encouraging people to get off of for myriad reasons.

 

With all that said, it is pretty clear at this point that substantially all of the benefit of SSRIs is from their placebo effect so to the extent the sertraline helped you it was really you helping yourself.  The challenge is that while you had no "chemical imbalance" when you began the meds, you have one now attributable to years of taking psych meds.  That does not mean, however, that you can't taper off of them slowly and successfully.  It is not easy but it can be done and the choice is yours.  If you elect to go in that route we would be happy to do our best to help.

 

Have you tried cleaning your diet completely?  In this regard, you might read Kelly Brogan's "A Mind of Your Own" in which she discusses the need to spend some time getting your body ready for a taper by eating well and learning ways to cope with triggers in your life.  You say you did some CBT?  When is the last time you tried that as a means of dealing with your intrusive thoughts?  Brain retraining is a real possibility given what we now know about neuroplastic change.  Bottom line is what you want to do on this score is always going to be up to you and if your gut is telling you it's time to try tapering off the meds, perhaps listening to your "inner voice" makes sense.

 

Best,

 

Andy

 

 

[Altostrata]

Welcome, rajan.

 

As apace (andy) says, we are a site for tapering off drugs.

 

Have you tried Cognitive Behavior Therapy or mediation for the symptoms that distress you?

 

Do you have any side effects from Zoloft? 30 years is a very long time for taking these drugs.