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Suggest Medication For OCD
Question: My Wife is suffering from Obsessive Compulsive Disorder (OCD). This is hereditary as her mother and aunt both have similar tendencies. This has been there for almost 15 years now and we have consulted multiple physicians/Psychiatrists. The last one was about 2 years ago and the main medicines were:
Floxin (40) - one tab a day (started with Floxin (60) , after 3 months started Floxin (40) and continued for more than a year.
DD Pramine (25) - 2 tabs a day for almost 1 year.
The medicines had some definite impact and there was a reduction in the tendency. Also she gained some weight.
We stopped it about an year ago since we really did not want to continue medicines for ever.
The symptoms are back and therefore I am seeking medical help again.
Mainly the symptoms are related to multiple times washing - hands, feet, utensils, clothes. She does not allow keeping maids as she feels they will not do the work 'Properly'. I provide lot of support in washing clothes and utensils. But even after that she rinses them with water once herself. In the morning she has a lot of tension as she feels she may not be able to do all the work 'Properly'. Again this is all in the mind.
She has lost weight again due to overwork. Food habits are normal, intake is ok, bowels are normal but at times on alternate days. Sleep is normal.
Please suggest some medicines (with minimum side effect) with dosage. Request to give a proper prescription, otherwise it is difficult to buy these medicines.
Please confirm whether we should use only the drug Floxin or also the other one DD Pramine.
Also please suggest the drug names for Vitamin B12 and Fatty acids as recommended by you
Thanks
XXXXXXX XXXX
Floxin (40) - one tab a day (started with Floxin (60) , after 3 months started Floxin (40) and continued for more than a year.
DD Pramine (25) - 2 tabs a day for almost 1 year.
The medicines had some definite impact and there was a reduction in the tendency. Also she gained some weight.
We stopped it about an year ago since we really did not want to continue medicines for ever.
The symptoms are back and therefore I am seeking medical help again.
Mainly the symptoms are related to multiple times washing - hands, feet, utensils, clothes. She does not allow keeping maids as she feels they will not do the work 'Properly'. I provide lot of support in washing clothes and utensils. But even after that she rinses them with water once herself. In the morning she has a lot of tension as she feels she may not be able to do all the work 'Properly'. Again this is all in the mind.
She has lost weight again due to overwork. Food habits are normal, intake is ok, bowels are normal but at times on alternate days. Sleep is normal.
Please suggest some medicines (with minimum side effect) with dosage. Request to give a proper prescription, otherwise it is difficult to buy these medicines.
Please confirm whether we should use only the drug Floxin or also the other one DD Pramine.
Also please suggest the drug names for Vitamin B12 and Fatty acids as recommended by you
Thanks
XXXXXXX XXXX
Brief Answer:
OCD can be treated with medicines and behaviour therapy.
Detailed Answer:
Hi, thanks for asking from HCM
I can understand your concern. The symptoms you've mentioned definitely suggest OCD and she has been diagnosed with this disorder already. For OCD treatment is done with SSRIs mainly and some times adjuvant drugs like TCAs or low dose antipsychotics are used.
Fluoxetine (which she was taking) is the drug of choice for OCD and the drug should be continued for long periods to maintain the sustained effect. OCD is a type of anxiety disorder that need continuous treatment. Concomitant use of Vitamin B12 and Omega 3 Fatty Acids helps a lot in increasing the effects of drugs.
The doses should also be in higher range. Dose of 60 mg per day should suit to control her symptoms. So if her symptoms are persisting then please start the drug again. Start with 20 mg then increase to 40 mg after 10 days and then increase the dose further to 60 mg per day. Keep her on this dose for at least 6-12 months to get best results.
Better to start with Floxin 20 then gradually increase dose to 60 mg. DD Pramin can be used in low doses if no response seen with Floxin.
Cobaday, Methylcobalamine 1500 mg is good form of B12. Omega Fatty Acid supplements are available with most chemist, you can choose any of them.
As this is an online portal and due to regulations its not possible to prescribe the drug by online prescription. Please visit a doctor for prescription.
Thanks, Hope this helps. Please don't hesitate to ask again for more doubts.
OCD can be treated with medicines and behaviour therapy.
Detailed Answer:
Hi, thanks for asking from HCM
I can understand your concern. The symptoms you've mentioned definitely suggest OCD and she has been diagnosed with this disorder already. For OCD treatment is done with SSRIs mainly and some times adjuvant drugs like TCAs or low dose antipsychotics are used.
Fluoxetine (which she was taking) is the drug of choice for OCD and the drug should be continued for long periods to maintain the sustained effect. OCD is a type of anxiety disorder that need continuous treatment. Concomitant use of Vitamin B12 and Omega 3 Fatty Acids helps a lot in increasing the effects of drugs.
The doses should also be in higher range. Dose of 60 mg per day should suit to control her symptoms. So if her symptoms are persisting then please start the drug again. Start with 20 mg then increase to 40 mg after 10 days and then increase the dose further to 60 mg per day. Keep her on this dose for at least 6-12 months to get best results.
Better to start with Floxin 20 then gradually increase dose to 60 mg. DD Pramin can be used in low doses if no response seen with Floxin.
Cobaday, Methylcobalamine 1500 mg is good form of B12. Omega Fatty Acid supplements are available with most chemist, you can choose any of them.
As this is an online portal and due to regulations its not possible to prescribe the drug by online prescription. Please visit a doctor for prescription.
Thanks, Hope this helps. Please don't hesitate to ask again for more doubts.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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