![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by ace on July 31, 2004, at 0:42:19
I have just ceased Remeron which did nothiong for my OCD and nothing for much else- except gave me horrendous heartburn and vomiting at night.
I have upped Zyprexa to 5mg. Since 2.5mg helps, maybe 4 weeks trial of 5mg will obliterate OCD
but after that what else can I try...?
I can only think of Carbamazepine (Tegretol)
Maybe some TCA's? (apart from Anafranil)Please, no suggestions of CBT or any talk therapy nonsense!
Ace
Nardil- 75mg
Zyprexa- 5mg
Xanax- 1-3mg
Posted by SLS on July 31, 2004, at 7:40:04
In reply to OCD- Need some new ideas guys!!!!, posted by ace on July 31, 2004, at 0:42:19
> Please, no suggestions of CBT or any talk therapy nonsense!I don't think it is at all helpful to characterize talk therapy as being nonsense. It might not be right for you for any number of reasons, but it is ever so right for countless others for many more.
- Scott
Posted by chemist on July 31, 2004, at 8:30:44
In reply to OCD- Need some new ideas guys!!!!, posted by ace on July 31, 2004, at 0:42:19
hey ace, chemist chiming in....first off, in my opinion Scott's advice is spot-on: i have been too medcentric in my posts and as a victim - i mean, subject - of therapy and meds, in my experience it's a winning combo when all parties are playing ball. next up: although my posts could probably be categorized as informative, useless, sarcastic, or some combination of thereof, a theme i have noticed is the use of luvox (fluvoxamine, as i do not know what y'all call it down-under) showing up recently and thus my initiative to reply. i take the stuff, and aside from parnate, it's the only anti-depressant i'd say was worth a darn for me. luvox is currently not available in the states - paperwork mistake on solvay's part, FDA said to address, so this is not a med-related issue, rather a secretarial blunder - but i do know it is available in other countries, and i take the generic 100 mg bid. the long and short of it is that luvox was approved by the FDA for the treatment of OCD, *not* depression, although it is an SSRI that hits a bunch of serotonin receptor subtypes. you might look into it, as you've been around the block with the others. it's a bit dicey to get the dose right - 50 to 400 mg/day is the range i have heard - but it's been good to me in re: side effects, ease of titration/cessation, etc. drop a line, and as usual, all the best.....yours, chemist
> I have just ceased Remeron which did nothiong for my OCD and nothing for much else- except gave me horrendous heartburn and vomiting at night.
>
> I have upped Zyprexa to 5mg. Since 2.5mg helps, maybe 4 weeks trial of 5mg will obliterate OCD
>
> but after that what else can I try...?
>
> I can only think of Carbamazepine (Tegretol)
> Maybe some TCA's? (apart from Anafranil)
>
> Please, no suggestions of CBT or any talk therapy nonsense!
>
> Ace
> Nardil- 75mg
> Zyprexa- 5mg
> Xanax- 1-3mg
Posted by ace on July 31, 2004, at 23:26:38
In reply to Re: OCD- Need some new ideas guys!!!!, posted by SLS on July 31, 2004, at 7:40:04
>
> > Please, no suggestions of CBT or any talk therapy nonsense!
>
> I don't think it is at all helpful to characterize talk therapy as being nonsense. It might not be right for you for any number of reasons, but it is ever so right for countless others for many more.
>
>
> - Scottsorry Scott- I qualify my statement: CBT and talk therapy is uselss for me, but if it works for others great, and its obviously not then nonsense for them...
Posted by ace on July 31, 2004, at 23:32:16
In reply to Re: OCD- Need some new ideas guys!!!! ?ace, posted by chemist on July 31, 2004, at 8:30:44
Thanks heaps Chemist....by the way, I am suffering a little memorey loss due to Xanax....do you have anyway to overcome that
im studying some preety heavy stuff now, and need
good memory!Cheers Chemist!
Ace
Posted by chemist on August 1, 2004, at 9:13:34
In reply to Re: OCD- Need some new ideas guys!!!! » chemist, posted by ace on July 31, 2004, at 23:32:16
> Thanks heaps Chemist....by the way, I am suffering a little memorey loss due to Xanax....do you have anyway to overcome that
>
> im studying some preety heavy stuff now, and need
> good memory!
>
> Cheers Chemist!
> Ace
>
hey ace, i wish i could give you a positive for the memory loss, but i can't....i take dexedrine as needed with luvox and xanax, and the luvox has enabled me to cut down on the xanax, so the dex helps and the decrease in xanax helps but the overall problem remains. i kind of get around it in that way and by taking most of my xanax towards the later part of the day. i know this is another ``non-answer'' answers, but this is how i deal with it....i think i had a different approach once but i seem to have forgotten it :) ...seriously, maybe the luvox will enable you to cut back on xanax, or somebody else will have a better fix for you in the short-term other than switching out to another benzo......all the best, chemist
>
Posted by Dr. Bob on August 1, 2004, at 17:56:30
In reply to Re: OCD- Need some new ideas guys!!!!, posted by SLS on July 31, 2004, at 7:40:04
Posted by don_bristol on August 2, 2004, at 14:26:29
In reply to OCD- Need some new ideas guys!!!!, posted by ace on July 31, 2004, at 0:42:19
> I have just ceased Remeron which did nothiong for my OCD and nothing for much else- except gave me horrendous heartburn and vomiting at night.
>
> I have upped Zyprexa to 5mg. Since 2.5mg helps, maybe 4 weeks trial of 5mg will obliterate OCD
>
> but after that what else can I try...?
>
> I can only think of Carbamazepine (Tegretol)
> Maybe some TCA's? (apart from Anafranil)
>
> Please, no suggestions of CBT or any talk therapy nonsense!
>
> Ace
> Nardil- 75mg
> Zyprexa- 5mg
> Xanax- 1-3mg
=========Ace, have you seen this article:
"OCD Medication: Adults" Michael A. Jenike, M.D.
Professor of Psychiatry, Harvard Medical School,
Chairman, OC Foundation Scientific Advisory Board
http://www.ocfoundation.org/ocf1050a.htmIt is a little bit dated but I know he replies (briefly) to most of his emails.
ISTR Jenike has written elsewhere that for OCD you needs to use meds like Zyprexa in conjunction with an SSRI.
Also have a look at
"The Expert Consensus Guideline Series:
Treatment of Obsessive-Compulsive Disorder"
http://www.psychguides.com/ocgl.html
Posted by temoigneur on August 3, 2004, at 20:18:29
In reply to OCD- Need some new ideas guys!!!!, posted by ace on July 31, 2004, at 0:42:19
>
Hello Ace, I'm sorry things are rough - Tramadol was a life-saver, for me, I don't know if you've tried it, I take it with 30mg, (about 3/4t) of dextromethorphan, twice a day to keep tolerance at bay. I forgot the dextromethorphan once, and started to feel agitated and anxious. I take it in the form of cough syrup, 'delsym' up here, just because it's so accessible. If you have any questions talk to amesansvie, he's very knowledgeable in this area. If this doesn't work for you, you might try codeine or morphine, which didn't work for me, I'll post an article for tramadol and morphine & OCD - I can't post the morphine article, follow this post, and read "possible new treatment for OCD" all the best.Ben
(morphine & OCD link)
http://www.cpa-apc.org/Publications/Archives/PDF/1997/Aug/LETTERS.PDF
Tramadol
UC Researchers Awarded United States Patent
Contact:
Angela Russo, angela.russo@uc.edu
(513) 558-4559
Cincinnati-- The University of Cincinnati (UC) has been assigned a United States patent for the use of the painkiller tramadol, also called Ultram®, for the treatment of obsessive compulsive disorder (OCD) and related disorders, such as eating disorders, body dysmorphic disorder, and Tourette's Syndrome. These related disorders have numerous similarities and frequently coexist with OCD.Approximately 3.3 million Americans suffer from OCD in a given year. OCD is a chronic and often disabling condition with symptoms ranging from depression to irrational fears to compulsive checking, arranging and hoarding. Nearly half of all people who suffer from this illness have limited benefit from traditional psychiatric medications. Thanks to an initial observation by Nathan Shapira, MD, a former resident of the UC Department of Psychiatry, treatment may now come from a painkiller.
While at UC, Dr. Shapira worked in the inpatient unit with Paul Keck, MD, the attending psychiatrist at the time and current professor of psychiatry and vice chair for research. Dr. Shapira was treating a patient who had severe OCD and Tourette's syndrome, a neurological disorder related to OCD, characterized by repeated involuntary movements and uncontrollable vocal sounds called tics. The patient was treated with codeine, a painkiller, which helped alleviate some of the tics but had no effect on the OCD. The patient became tolerant to the drug and was give tramadol instead. The patient's symptoms significantly decreased within 24 hours.
"In some patients, tramadol can even take affect and decrease symptoms within 30 minutes to an hour," Dr. Shapira said. "Traditional drugs used to treat these illnesses have to be taken for at least 8-12 weeks before any response is apparent. This drug is unique in that it can be taken on an as-needed basis and can have an immediate response time."
As a result of this finding, Drs. Shapira and Keck in conjunction with Toby Goldsmith, MD, a former assistant professor of clinical psychiatry at UC, now a clinical assistant professor of psychiatry at the University of Florida, designed a small clinical trial to test the drug. Patients enrolled in the study had no previous response to other treatments. The results of the study were favorable.
"All the patients we have studied have had anywhere from 25-65 percent relief from their symptoms," Dr. Shapira said. "A moderate response that certainly was an improvement in their lives."
Dr. Shapira, currently an assistant professor of psychiatry at the University of Florida, says tramadol is not a cure, but is a step in the right direction. The drug is FDA-approved for use as a pain killer, but further research needs to be done to get FDA approval for its use to treat OCD and related disorders.
"There are a lot of people that do not experience substantial benefit from treatments for OCD," he said. "With further research and clinical trials, we will be able to find out more about this drug and how it works and develop even better treatments for this illness."
Since tramadol is a mild opiate, there is some risk of addiction. However, Dr. Shapira says the drug has a low physical dependence and abuse level and is mild enough that its benefits for people who are disabled by OCD often outweigh the negatives.
I have just ceased Remeron which did nothiong for my OCD and nothing for much else- except gave me horrendous heartburn and vomiting at night.
>
> I have upped Zyprexa to 5mg. Since 2.5mg helps, maybe 4 weeks trial of 5mg will obliterate OCD
>
> but after that what else can I try...?
>
> I can only think of Carbamazepine (Tegretol)
> Maybe some TCA's? (apart from Anafranil)
>
> Please, no suggestions of CBT or any talk therapy nonsense!
>
> Ace
> Nardil- 75mg
> Zyprexa- 5mg
> Xanax- 1-3mg
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.