How is that even possible.

[vannpire]

Hi, me again. I've got a problem. I feel like my mind is 5 or 6 months aback... before I started my medication treatment. Is it possible that this is due to lowered dosage of anafranil? I'm currently taking anafranil - twice daily, one morning and one evening. Stimuloton - 3 morning and fluanxol - 2 evening. I went from 6 anafranils daily to 2 - gradually over the last 2 weeks (because of side effects like severe constipation and inability to ejaculate). I have scheduled a new appointment with my psychiatrist, but that's a week from now, so I was wondering if anyone could provide any insight into my situation. I'm worried that all is going back to when it started or... even worse, I am starting to feel that the little progress I was making (even if super slow) is now going nowhere. I feel lost... This is already the third time we're changing treatment and what if nothing works the forth time? :/

Thanks for reading.

[deValentin]

Have you tried psychotherapy? Some medication may lose its effectiveness ove time, especially if you lower dosage. Let alone its side effects.

[vannpire in reply to deValentin]

No, I haven't started yet, my psychiatrist suggested I wait a little more until we find the right meds.

[deValentin in reply to vannpire]

I'm not a health professional, so what I'm going to say isn't meant to replace your psychiatrist' suggestion, but if you try ERP (exposure and response prevention) and you get results, why take pills? If you first need to find a chemical way to make your OCD manageable before undertaking psychotherapy, what incentive would you have to do the latter?

If you don't get positive results with ERP alone, that's a different story. Skills before pills.

I guess it depends upon one's beliefs. If one thinks OCD is caused by a "chemical imbalance" in one's brain, one will tend to favor medication. If one thinks that OCD is mainly caused by faulty reasoning and inappropriate past responses to triggering circumstances, one will tend to first try psychotherapy. Medication is sometimes used to make a change of behavior, which is difficult, temporarily more bearable. Any behavior that offers immediate rewards or relief from anxiety but long-term disadvantages will be difficult to change at first.

I reckon that experts haven't yet figured out why some people respond well to ERP alone, and others seem to need a combination of ERP and medication.

[vannpire in reply to deValentin]

Will look into ERP, thank you!

[deValentin in reply to vannpire]

You're welcome.

In regard to ERP, Jonathan Grayson, an OCD expert, proposes an interesting thought experiment in Freedom from Obsessive-Compulsive Disorder. Imagine you have a gun pointed to your head and being asked the question, for instance, "Is the front door open?" with the stipulation that the trigger will be pulled if you give the wrong answer. In most cases, people with checking OCD, that is, people who find it more difficult than usual to decide whether a door is locked, will give the same answer than those who aren't suffering from OCD. "The Gun Test is an aid to help you distinguish between what you intellectually and logically know from what you feel" (p. 12).

In the real world there is no immediate perceptible penalty if you take too long to decide whether a door is locked when you believe that "one more check" will help you decide. Deciding that good reasons are enough to appease one's mind, that is, practicing ERP, is a good way to function reasonably well in this world without having a gun to one's head.

[80_Zil_ian]

Hello, yes, it is possible to feel some steps back in the treatment. I never took the medicines you described, but others.

In 2010, before starting sertraline, I was taking risperidone and fluoxetine. I felt an enormous improvement in two months, but after that, the OCD found its way again, and I was back to zero. It was terrible, so the doctor changed the medication to sertraline, and it worked. I believe it's common; it is all a matter of finding the correct treatment and dose. Keep checking with your doc, and when necessary, seek for a second opinion.

[vannpire in reply to 80_Zil_ian]

Thank you! I hope we can finally find something that will work for me, too. Psychiatrist said she has an idea as of what we should do next, so we'll see...

[Coffeelove4444]

I am on Anafranil 100mgs. My doctor added Rexuli .. only . 5 mgs . It has really helped. Keep pushing forward and you will find something that works. Make sure your diet includes lots of fibre to help with constipation from meds. Build your toolbox that is helpful for you.

[vannpire in reply to Coffeelove4444]

My diet is rich in fiber, but my doctor explained that it has something to do with the effect anafranil has on the pelvis - not sure what exactly, but she said that it happens with some patients. Hopefully I find something that works sooner.

[Phoenyx]

Hello there. I was in your boat. From the beginning of the year until now I have changed three medications. When I feel hopeless I ask myself "do I have another option but to continue fighting?" If this medication doesn't work, I will go on the next one. I want this nightmare over and I cannot give up. I've read books on acceptance, did ERP but my anxiety is so severe that I cannot live without medications. A lot of times I have anxiety which is unrelated to OCD. OCD doubts everything, even if you will ever get better. You will find the right meds and the right dose, and get better.

[vannpire in reply to Phoenyx]

Same here with anxiety. Can't seem to get rid off it so far. I can feel it's a tad better, but there's still room for improvement. At least now I care a bit less when I'm out of the house. Good luck to you, hope you get your anxiety under control for good!

[Sallyskins]

Is there a reason why you're on clomipramine (Anafranil) - like other drugs have been tried and not suited you? I took it for many years, and it worked well for me, except that I felt really dopey constantly - actually occasionally fell asleep across my desk at work!

First introduced in around 1968, it was hailed as a wonder drug, and it can be very effective. But it's now only prescribed in cases where SSRI antidepressants haven't worked well.

It's best to start on CBT and ERP straightaway - medication makes it easier, but the CBT and ERP do the work. And although progress may be slow, just a little relief from the OCD can make a huge difference to your life.

[vannpire]

I started off with Zoloft and then switched to Anafranil. I didn't feel any positive effect from Zoloft, granted I didn't take it for more than a month and something, but still... side effects were present. I will ask again for CBT and ERP. The thing is - I feel good one day, then the next day I could feel like before I started treatment. So I don't know... it confuses me. Just when I think meds are finally working, next day may prove me wrong. Hopefully the next medication will be THE one for me and I can finally start making better improvement!