
Suggest Better Medications For Anxiety, Negative Thoughts And OCD

Patient is suffering with anxiety, negative thoughts and OCD i.e. continuously looking at the door repeatedly and checking whether it is close or not, having fear from crowd, etc.
She is 45 years of age and suffering since last 5 years.
Initially nexito- 20 mg along with sizdon- 1mg per day was taken on the advice of doctor for 2 years and situation has improved but not cured fully. Medicine was discontinued and the situation became poor gradually in 3 years.
Last 3 months nexito - 10 mg along with sizdon - 0.5 mg per day was taken and situation improved to some extent.
Doctor has advised to take only nexito 20 mg per day since last 10 days, but the condition is not satisfactorily improving.
Kindly advice a permanent and complete cure.
Nexito (escitalopram) is not approved for OCD.
Detailed Answer:
Hello
Welcome to HCM.
OCD co-morbid with depression is difficult to treat.
OCD is a chronic, relapsing disorder and 100% cure is very difficult.
The patient has to take drugs regularly to keep his/her symptoms under control.
Another important thing in treatment of OCD is that Nexito (escitalopram) is not approved by FDA for OCD treatment.
In my opinion, the better choice is fluoxetine (max dose-120mg) or sertraline(max dose-200mg).
She should be started with single drug (either fluoxetine or sertrailne) with low dose and dose can be increased gradually depending on the response.
Also, as he condition is not improving with nexito, this also an indication for change of drug.
If she does not respond to the single drug, the augmenting drug of choice should be clomipramine and not sizodon (its an antipsychotic).
Sizodon is a third-line agent in OCD or it is used if psychotic symptoms are present.
Kindly discuss these issues with her doctor. Please do note that all the drugs mentioned above are prescription drugs.
Hope this helps.
Feel free to ask further.
Thanks.

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