Update on our daughter and questions about TMS for OCD

[Dadof2kids3cats]

Hello,

Our daughter Lynn is doing somewhat better with her health OCD than she was a month or two ago. She has made fewer visits to the ER recently and is doing somewhat more to engage in life—e.g., traveling downtown on her own to attend theater performances and signing up for a community college course that she thinks would be interesting for the winter/spring semester. Her Prozac dosage was raised to 80 mg some weeks ago and was briefly raised to 100 mg, but at 100 mg she showed some early indications of serotonin syndrome so we are back down to 80 mg. Her psych provider is also starting her on lamotrigine, which is a glutamate modulator that has shown some benefits as an adjunctive medication for OCD treatment; we are also starting her on 7.5 mg l-methylfolate, a non-prescription supplement that her provider suggested as possibly helpful. She continues on buspirone and (for now) clonazepam.

We are cautiously hopeful that once she has been on 80 mg of Prozac for long enough and once the lamotrigine has reached an effective dose, she will see further improvement. However, we are also thinking about alternatives if she is still not doing well enough at that point to more fully re-engage in life.

In particular, she and her provider have discussed the possibility of referring her for TMS for OCD (we are lucky to have this available in the DC area.) This certainly seems like a possible next step, but one concern I have is that it seems the extensive time commitment needed to complete a course of TMS, and what sounds like a likely need to repeat this every year or so, could make it difficult for Lynn to lead a normal life even if it provided effective symptom control. In particular, it seems like this would dramatically limit the employment options that she could pursue. It might also make graduate study more difficult, although it seems at least somewhat plausible that one could schedule coursework and treatments around each other.

So, I am interested in hearing from any of you who have had experience with OCD-specific TMS treatment, or know others who have, both with regard to how it has worked out in general, and in particular with regard to the extent to which treatment has interfered with employment, schooling, or other activities. Thank you!

[Sallyskins]

Thanks for updating us about your daughter. It does sound as though she has made progress - often these little steps make a big difference. And being able to do more things - going out to the theatre and signing up for college - these all go to taking her mind off OCD. Having OCD often feels like a full time job - but the more you can do the less room there is for OCD thoughts to creep in.

I can't comment much about TMS as I haven't had it myself. But I think it could be well worth giving it a go. At the moment, a normal life is difficult when someone has OCD - employment or graduate study might be easier for her if she can get the OCD under control. A sympathetic employer or college/university could make allowances for her to have the TMS.

From my own experience, the more you get OCD under control, the more you can do, and the more you can do, the more OCD takes a back seat.

May I offer good wishes for the festive season to you and your family?

[Dadof2kids3cats in reply to Sallyskins]

Thank you!