Hello everyone. About a month ago I was out on Paroxitine starting with 10mg a day. In about a week, my anxiety was completely blocked but I still experienced raising intrusive thoughts. However towards week two of being on 10 mg my anxiety came back and all my symptoms that were suppressed were present. My doc then put me on 20 mg and this same exact thing has happened again. By week one I was better but then towards week two everything came back. Has anyone experienced this? Any suggestions or advices?
Needless to say that makes me feel discouraged and very disappointed
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Phoenyx
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Hello! The situation you described is very common. There are three scenarios here:
1. The medicine worked for a while, but OCD is stubborn and strong, finding its way back. This first scenario happened to me 14 years ago. I felt great for three months with Fluoxetine, but it suddenly lost its effect on OCD, and I was back at square one. After some time persisting without results, I eventually had to switch to Sertraline (100mg), which worked and has continued to work even after more than a decade.
2. It’s only a matter of time. The medicine and dose are correct, but your mind is still adapting, and relapses are expected.
3. It’s just about adjusting the dose, as your doctor has already done.
Thank you so much for you reply. I have an answer tomorrow and hopefully will have some clear view on what might be happening. I really needed the support. Thank you.
I have had OCD since I was 9 years old . It’s been controlled by therapy and very very low dose of Prozac for my entire life (I’m 62) . Although I considered my OCD as “controlled “ there has always been a nawing underlying anxiety, even if I wasn’t acting out on my compulsions most of the time .
Looking back , the slight relief that I experienced was due to the lowest dose of prozak, then recently , sertraline 25 mg … it wasn’t until a recent event that my forever anxiety was called out as OCD and my Dr said “Lets up the dose” .
As a result , 2 weeks ago we decided to up my dose to 50 mg of sertraline . OMG my world has changed . My “ anxiety “ and things that I considered “ normal behavior” ( over washing dishes, over worrying about my son and daughter … ) I no longer care about .
Life feels a lot different. I am looking forward to going up on the dosage to perhaps realize that more things that I consider “normal anxiety “ are really OCD in disguise .
Are you relying exclusively on medication to control your OCD, or are you also undertaking some form of cognitive-behavioral therapy? We're often better off not putting all our eggs in the same basket. There are no side effects with ERP, and once it produces some results, it's a matter of keeping practicing it to get the same effects. In other words, the effects of ERP don't fade if you keep practicing it.
I know you are a huge advocate for ERP and it helps with recognizing the compulsions, not performing them and tolerating anxiety. However I have anxiety even without intrusive thoughts. My anxiety is almost non stop. So yes, I’m relying on meditation for anxiety because it’s no fun waking up afraid and shaking. I think my OCD made my brain stuck in fight, flight, freeze mode.
I'm not against medication. Drugs sometimes have a place in a treatment plan. The problem is that they don't discriminate between healthy and unhealthy anxiety. CBT does.
Anxiety has a role positif to play. If, for instance, I choose to perform in a play, I'll be anxious beforehand because I want to play well, but I'm not sure I can do it and how the public will react. It's a sign I care about something and I recognize nothing is granted. Anxiety motivates me to mobilize all my ressources in reaching a challenging goal, and once the action starts, anxiety diminishes.
In some cases, anxiety can be crippling and not based on a realistic assessment of reality. Why, for instance, should I be afraid to board a plane but not drive, when the probability of a road accident is higher? With CBT, you learn to better manage risks and to live your life in such a way as to give yourself good reasons to feel safe and be satisfied with those reasons. You learn to trade off short-term comfort for long-term benefits. It's not always an easy road.
Some people take benzos, for instance, to calm their anxiety. Sure, it works short-term, but after their effect wear off you're in a worse state than before. I understand that they may be necessary on a temporary basis while waiting for CBT to work, but if there is no plan to learn better coping skills research shows that they deliver poorer results.
A lot of research has been done on brain plasticity. It has been learned that the brain is rarely irremediably stuck in one mode. It's a very adaptable organ. But, for those who lost hope of getting better without medication, the brain may seem stuck in one mode. I understand that.
Of course, it's up to each one of us to read the research, experiment with different methods, and decide what's best for them.
I agree that CBT helps . I was on the lowest dose of meds for years …. 20 mg Prozak, then switched to 20 mg sertraline , I considered that helpful… I continued going to CBT therapy for many years and learned how to ease my Anxiety and how to differentiate real anxiety vs Over reactions. Now that CBT is engrained into me ( grateful for this) , I recently had a situation where I realized , this is OCD ! Not a normal reaction. Certain “normal “worries that I was living with for many years were called out as OCD
My therapist suggested upping my dosage 2 weeks ago to 50 mg sertraline , and I Feel like a new person !!! For years I thought my worrying was normal , now I definitely see it was still OCD being sneaky . So therapy is great , but WOW the medicine does make a difference . Looking forward to maybe increasing it further
Yes, I agree that meditations help. I’ve been spoiled and lucky that meds had been working for me for years and never needed a therapy. But now I have a therapist that is trying to understand all possible reasons for my worsening and I’m ready to learn ways to cope with OCD and anxiety.
I'm glad it's presently working for you. But what about the long term? ERP is free, has no side effects like weight gain, and doesn't wear out if, on a regular basis, you abstain from engaging in compulsions while investing time and energy in OCD-free activities.
Sure, antidepressants often lessen the frequency and intensity of intrusive thoughts. But don't intrusive thoughts have a positive role to play? Let's say I lost my wallet. A lot of disturbing thoughts pop into my mind. What if it was stolen? What if my credit cards are being used right now? Those disturbing thoughts are giving me a great incentive to search for it and do some damage control. I know a family member on antidepressants who once lost her purse, and didn't seem much disturbed by the event (blunting effect). That's scary, in my opinion.
The ADAA (Anxiety and Depression Association of America) put out an interesting paper on the subject entitled "New Concerns Emerge About Long-Term Antidepressant Use".
If you watch videos on the Internet and do it yourself, it's free. Well, it only costs time and efforts. If you see a therapist, then, yes, you'll have to pay.
I am also on Paroxetine, 20 mg. I have been up to 30 mg. I have this medication for several years (!). Its effect is optimal after a couple of months. It will not suppress totally your anxiety but will help you to go ahead in your life. While on medication, you can follow a therapy. That is what I do.
Doctors have other products but do not feel discouraged too quickly with this one
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