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Suggest Medication For Fast Symptomatic Relief In A Person With OCD And Anxiety
Question: Hello. I suffer from OCD/anxiety/ADD. I will start a master in september and need something that works. I am currently taking celexa 10mg at night time. It works on the aniety but at a very high price. I'm tired all day, and my odd gets worse because of my lack of awareness. My goal every day is just to get things done fast so I can get home and sleep. I am concerned that I won't be able to study and perform well at school. In the past I also tried Vyvanse (ADD), it worked but it didn't last long enough and was unhappy because of that. prozac, pristiq (similar effect as celexa).
I should also add that I likely suffer from some sleep disorder. I had 2 nose surgeries in my life for breathing issues. On top of it I also have very low blood pressure and a low heart beat that makes me even more tired.
I need a combination of SSRI and I believe something else that keeps me away from anxiety but also alert. I was thinking to try provigil or nuvigil (not sure which is better), and maybe consider changing celexa, since it does not interact well with either of those.
I would appreciate your advice
I should also add that I likely suffer from some sleep disorder. I had 2 nose surgeries in my life for breathing issues. On top of it I also have very low blood pressure and a low heart beat that makes me even more tired.
I need a combination of SSRI and I believe something else that keeps me away from anxiety but also alert. I was thinking to try provigil or nuvigil (not sure which is better), and maybe consider changing celexa, since it does not interact well with either of those.
I would appreciate your advice
Brief Answer:
I recommend nuvigil, Go for cognitive behavior therapy also
Detailed Answer:
Hello Young Man,
Thanks for writing to us.
You have OCD/anxiety/ADD. For fast symptomatic relief low dose benzodoazepine in day time may help which can be tapered off fast.
Go for serum B12 level and thyroid level as deficiency of any of them may lead to fatigue.
Celexa is a good medicine. But for anxiety and alertness I recommend prozac in morning after breakfast. And if you want to add another SSRI I suggest paroxetine at night which helps in sleep also.
Provigil and Nuvigil both are alerting agent. I recommence Nuvigil as less side effects and easily tolerable. Take it in day time only.
Considering your age and concern about future study of Masters I recommend to go for cognitive behavior therapy (CBT) also. It will be effective in addiction to improvement by medicines.
And last but not the least if your symptoms of ADD continue and you are not happy with Vyvanse, wellbutrin (Bupropion) is good option.
You can discuss above aspects with your treating doctor and can change treatment approach.
All the best.
Hope this answer will help, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
I recommend nuvigil, Go for cognitive behavior therapy also
Detailed Answer:
Hello Young Man,
Thanks for writing to us.
You have OCD/anxiety/ADD. For fast symptomatic relief low dose benzodoazepine in day time may help which can be tapered off fast.
Go for serum B12 level and thyroid level as deficiency of any of them may lead to fatigue.
Celexa is a good medicine. But for anxiety and alertness I recommend prozac in morning after breakfast. And if you want to add another SSRI I suggest paroxetine at night which helps in sleep also.
Provigil and Nuvigil both are alerting agent. I recommence Nuvigil as less side effects and easily tolerable. Take it in day time only.
Considering your age and concern about future study of Masters I recommend to go for cognitive behavior therapy (CBT) also. It will be effective in addiction to improvement by medicines.
And last but not the least if your symptoms of ADD continue and you are not happy with Vyvanse, wellbutrin (Bupropion) is good option.
You can discuss above aspects with your treating doctor and can change treatment approach.
All the best.
Hope this answer will help, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello.
I had my Vitamin B12 tested and the values were ok.
I have tried Prozac before and It was not much different from Celexa.
You are advising me to mix two SSRI's which is not generally recommended to begin with.
I want to take Nuvigil, but it has an interaction with Celexa, that's why I wanted to switch to a different SSRI, but choose one that keeps me awake and with the smallest side effects possible.
I have tried CBT in the past (before the medicines) with small success. However, I find that with the SSRI'S I always feel to lazy to even attempt.
My goal right now is to find a medicine that can work with Nuvigil, while also not with the same side effects of Celexa. I don't currently have a threading Doctor, because In canada the System is stupid. But I'll be in europe for school and in Italy I have access to medicines without the need of a prescription. I just need advice on the right combination based on my situation.
Thank you,
XXXXX
I had my Vitamin B12 tested and the values were ok.
I have tried Prozac before and It was not much different from Celexa.
You are advising me to mix two SSRI's which is not generally recommended to begin with.
I want to take Nuvigil, but it has an interaction with Celexa, that's why I wanted to switch to a different SSRI, but choose one that keeps me awake and with the smallest side effects possible.
I have tried CBT in the past (before the medicines) with small success. However, I find that with the SSRI'S I always feel to lazy to even attempt.
My goal right now is to find a medicine that can work with Nuvigil, while also not with the same side effects of Celexa. I don't currently have a threading Doctor, because In canada the System is stupid. But I'll be in europe for school and in Italy I have access to medicines without the need of a prescription. I just need advice on the right combination based on my situation.
Thank you,
XXXXX
Brief Answer:
Wellbutrin or prestique is an option
Detailed Answer:
Hello XXXXX,
Nuvegil increases level of almost all SSRI according to some study and the most one is escitalopram.
In this case if you want to take SSRI with nuvegil dose should be on lower side of the SSRI.
And other option is to use wellbutrin(bupropion) or Prestique (Desvenlafaxine) which does not interact with nuvegil.
Prestique is with the least side effects.
Hope this answers your concern. Feel free to discuss further.
Take care.
Wellbutrin or prestique is an option
Detailed Answer:
Hello XXXXX,
Nuvegil increases level of almost all SSRI according to some study and the most one is escitalopram.
In this case if you want to take SSRI with nuvegil dose should be on lower side of the SSRI.
And other option is to use wellbutrin(bupropion) or Prestique (Desvenlafaxine) which does not interact with nuvegil.
Prestique is with the least side effects.
Hope this answers your concern. Feel free to discuss further.
Take care.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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