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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Skee on May 5, 2002, at 8:30:40
Hello everybody. I've recently had a relapse of my OCD. Not pleasant. I have in the past used Anafranil with very good results. I tried to restart Anafranil and found that it wasn't helping, and in fact seemed to make it worse. This time the side effects were intolerable. I have previously been on a very small dose of Prozac (10 mg.) and a small dose of Paxil (10 mg.). The Prozac works well but makes me a bit wired. My thought is that on a higher dose I will feel more wired and spaced out. Sleeping (or lack of sleep) is directly tied into my OCD, so it is important that I have a medication that helps me sleep. I also have very high levels of anxiety - wake up in the night - my OCD is worse at that time - feeling extreme anxiety. I was thinking about starting Paxil again at a higher dose but am unsure about how it will affect my sleeping.
My Doctor has me on a small dose of Remeron at the moment. It seems to help my OCD and at first helped with sleep. Not so much any more. It also makes me mean and hungry! The hungry I can tolerate, but I think if I continue with my shrewish attitude/mood, I'll be in the divorce courts before long! Has anyone else had this side effect?? On the plus side - sex is not at all affected! It's great "physically". (However, my crabby self still inhabits the bed! Not sure if my HUSBAND will be interested much longer.)
Looking for suggestions on medication choices. You guys have all the info. What can you suggest.
In a nutshell, I need a med to help with:
OCD
Anxiety
SleeplessnessThanks guys!
Posted by fairnymph on May 5, 2002, at 9:33:32
In reply to Recommended Med. for OCD - As good as Anafranil, posted by Skee on May 5, 2002, at 8:30:40
I have OCD, and I have taken a variety of antidepressants in attempts to treat it. My depression and anxiety (OCD related, obviously) are quite bad as well.
I hated Remeron, as it made me far too lethargic (sleeping 12-14 hrs a night, was sleepy throughout the day, felt foggy-headed). I started out on a low dose but quickly moved up to the maximum dosage of 60 mg, as I was not responding to the medication (and in fact, never did). I too had an appetite increase and gained 10% of my body weight over 6 weeks (and I am thin naturally, and not at all prone to weight gain). I flipped out and fell into a moderately severe depression. I definitely was not happy on the Remeron (I hated being so lethargic), but I'm not sure if it exactly made me 'mean'. It could just be your personal response, or else perhaps it is a side effect that will subside with continued treatment -- how long have you been taking the Remeron?
I found the SSRIs to be very effective but I could not tolerate the sexual side effects. Same for Effexor. I think that if you found paxil/prozac too 'stimulating' then avoid the other SSRIs and definitely avoid Effexor!
I say stick with the Remeron for a bit longer, and if that doesn't work, consider trying some of the other tricyclics (as you seemed to respond well to Anafranil).
Some other anti-anxiety, antidepressants that are not typically used for OCD, but which might suit your purposes, and are not 'stimulating':
Nefazadone
Mianserin
TrazadoneI have not tried any of the above, as I require a stimulating AD as opposed to a sedating one.
Posted by Ritch on May 5, 2002, at 11:03:38
In reply to Recommended Med. for OCD - As good as Anafranil, posted by Skee on May 5, 2002, at 8:30:40
> Hello everybody. I've recently had a relapse of my OCD. Not pleasant. I have in the past used Anafranil with very good results. I tried to restart Anafranil and found that it wasn't helping, and in fact seemed to make it worse. This time the side effects were intolerable. I have previously been on a very small dose of Prozac (10 mg.) and a small dose of Paxil (10 mg.). The Prozac works well but makes me a bit wired. My thought is that on a higher dose I will feel more wired and spaced out. Sleeping (or lack of sleep) is directly tied into my OCD, so it is important that I have a medication that helps me sleep. I also have very high levels of anxiety - wake up in the night - my OCD is worse at that time - feeling extreme anxiety. I was thinking about starting Paxil again at a higher dose but am unsure about how it will affect my sleeping.
>
> My Doctor has me on a small dose of Remeron at the moment. It seems to help my OCD and at first helped with sleep. Not so much any more. It also makes me mean and hungry! The hungry I can tolerate, but I think if I continue with my shrewish attitude/mood, I'll be in the divorce courts before long! Has anyone else had this side effect?? On the plus side - sex is not at all affected! It's great "physically". (However, my crabby self still inhabits the bed! Not sure if my HUSBAND will be interested much longer.)
>
> Looking for suggestions on medication choices. You guys have all the info. What can you suggest.
>
> In a nutshell, I need a med to help with:
>
> OCD
> Anxiety
> Sleeplessness
>
> Thanks guys!
Hi,Remeron made me very irritable and grouchy and it never seemed to go away (I have bipolar with anxiety probs. and panic history). Sleep disruption *greatly* aggravates all of my symptoms, too. BTW, I noticed on Remeron that if I pushed the dose up to around 30mg I would have lucid dreaming episodes at night where I could't really tell if I was awake or dreaming-and then I would just feel groggy and irritable all day the next day. You might try *reducing* your Remeron dosage to see if you can sleep more soundly before you ditch the Remeron completely. It works wonderfully for GAD/panic. As far as alternatives to help your symptoms.. I took Prozac for about seven years running and it helped a lot, but it was very very sleep disruptive (so was Zoloft). I think the Paxil would be a better idea. You might try 5mg at bedtime and then 5mg midday the next day and spread it out. If you take *too* much at bedtime it could be sleep disruptive like all SSRI's tend to be. There are some other non-SSRI/Anafranil add-ons that could help your OCD. You could try some Neurontin (say 300-400mg) at bedtime. Klonopin at bedtime might also help.
good luck,
hope this helps,Mitch
Posted by tex1 on May 5, 2002, at 12:17:59
In reply to Recommended Med. for OCD - As good as Anafranil, posted by Skee on May 5, 2002, at 8:30:40
> Hello everybody. I've recently had a relapse of my OCD. Not pleasant. I have in the past used Anafranil with very good results. I tried to restart Anafranil and found that it wasn't helping, and in fact seemed to make it worse. This time the side effects were intolerable. I have previously been on a very small dose of Prozac (10 mg.) and a small dose of Paxil (10 mg.). The Prozac works well but makes me a bit wired. My thought is that on a higher dose I will feel more wired and spaced out. Sleeping (or lack of sleep) is directly tied into my OCD, so it is important that I have a medication that helps me sleep. I also have very high levels of anxiety - wake up in the night - my OCD is worse at that time - feeling extreme anxiety. I was thinking about starting Paxil again at a higher dose but am unsure about how it will affect my sleeping.
>
> My Doctor has me on a small dose of Remeron at the moment. It seems to help my OCD and at first helped with sleep. Not so much any more. It also makes me mean and hungry! The hungry I can tolerate, but I think if I continue with my shrewish attitude/mood, I'll be in the divorce courts before long! Has anyone else had this side effect?? On the plus side - sex is not at all affected! It's great "physically". (However, my crabby self still inhabits the bed! Not sure if my HUSBAND will be interested much longer.)
>
> Looking for suggestions on medication choices. You guys have all the info. What can you suggest.
>
> In a nutshell, I need a med to help with:
>
> OCD
> Anxiety
> Sleeplessness
>
> Thanks guys!
The most powerful SSRI for OCD is definetely LUVOX. You might have a try on this one at the dosage of 50 mg for one week and increasing the second week to 100 mg. It's also very useful for sleeplessness. A really grat drug.Best luck
Tex
Posted by rainbowlight on May 6, 2002, at 1:34:07
In reply to Recommended Med. for OCD - As good as Anafranil, posted by Skee on May 5, 2002, at 8:30:40
I have OCD and GAD too. I take Lamictal, Remeron, and just recently added Zoloft. Zoloft has been a miracle drug for me. It drastically reduced my anxiety and OCD. I take 50 mgs. which is a pretty low dose, if I try to up it I get irritable. I tried Luvox (too sedating and made me severely agitated) and Paxil (also too sedating). Others swear by these though. I personally do not think that Remeron helps with anxiety (at least not for me) but it works wonders for depression. Small doses of Risperdal or Seroquel work well for people for anxiety too. I hope you find some relief soon, I know how hard it is to find something that works. Good luck.
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