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Suggest Remedy For Depression And Anxiety Along With OCD
Question: Hi..
I am a 30 years old unmarried lady.For last 12 years I have been suffering from OCD and the symptoms are completely based on irrational intrusive thoughts.For all these 12 years I have been on medication Fluvoxine CR 150 mg.I had been doing really well with the medicine and whenever I showed any exaggeration in obsessive thoughts,my doctor increased the dose to 200 mg and then slowly tapered it down to 150 mg (in case of improvement). I have been very regular and punctual about my medicine and never quit taking it.
But for last two months,I noticed that the symptoms of OCD have emerged gradually to great extent while I was on the dose of 150 MG. My doctor increased the dose to 200 MG.I got no relief.Then He increased the dose to 250 MG and also prescribed me to take Lonazep 0.25 mg(twice/daily) long with fluvixine CR 250 mg.But I am not having much relie and I have terrible bouts of depression and anxiety.What is worrying me more is that I had been doing so well with the medicine for last 12 years.How come it stopped showing its effects now after 12 years when I am already on a high dose of this medicine.I am very much worried as my problem has started affecting my personal and professional life.I also don't take the Lonazep in routine for last one month because I don't want to be the addict of this sedative.Please suggest why my problem suddenly emerged so badly while I was already on medication of Fluvoxine CR and why this medicine has stopped showing any relief .Also suggest that is it necessary to take Lonazep daily or should I take it only when I have a bad day full of anxiety.I have also heard that Vit D deficiency is also a reason behind depression and my Vit D level is very low i.e less than 4. Please suggest what should I do as I am terribly tensed.
I am a 30 years old unmarried lady.For last 12 years I have been suffering from OCD and the symptoms are completely based on irrational intrusive thoughts.For all these 12 years I have been on medication Fluvoxine CR 150 mg.I had been doing really well with the medicine and whenever I showed any exaggeration in obsessive thoughts,my doctor increased the dose to 200 mg and then slowly tapered it down to 150 mg (in case of improvement). I have been very regular and punctual about my medicine and never quit taking it.
But for last two months,I noticed that the symptoms of OCD have emerged gradually to great extent while I was on the dose of 150 MG. My doctor increased the dose to 200 MG.I got no relief.Then He increased the dose to 250 MG and also prescribed me to take Lonazep 0.25 mg(twice/daily) long with fluvixine CR 250 mg.But I am not having much relie and I have terrible bouts of depression and anxiety.What is worrying me more is that I had been doing so well with the medicine for last 12 years.How come it stopped showing its effects now after 12 years when I am already on a high dose of this medicine.I am very much worried as my problem has started affecting my personal and professional life.I also don't take the Lonazep in routine for last one month because I don't want to be the addict of this sedative.Please suggest why my problem suddenly emerged so badly while I was already on medication of Fluvoxine CR and why this medicine has stopped showing any relief .Also suggest that is it necessary to take Lonazep daily or should I take it only when I have a bad day full of anxiety.I have also heard that Vit D deficiency is also a reason behind depression and my Vit D level is very low i.e less than 4. Please suggest what should I do as I am terribly tensed.
Brief Answer:
Lonazep is not necessary
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query and understand your concerns.
First of all about your non response to Fluvoxamine due to following things.
1. Change in batch no. of medicines- No two batches of medicines are similar and it is possible that current batch of your medicine is not equivalent of previous dosages. This is more likely when you are on generic medicines. If this is the possibility shift to older batches or use the branded one rather than generic one. I am aware that there is drug control policy but no harm in checking this.
The second possibility is emergence of new stressor in recent months. When we are stressed the need for medication is higher. If this is the case there is need to deal the problem without delay.
The third possibility is that due to prolonged condition of OCD there are some changes in brain which make the drug less effective. In such scenario increase of dose helps and in my view your psychiatrist is right in increasing the dose to 250 mg a day.
There are some theories that with prolonged use SSRI becomes ineffective. There is no substance behind such theories but it is possible that due to one or another reason the theory is applicable for you.
Whatever the case I request you to enroll your self for psychotherapy along with medication. There is enough evidence to show that combination works better and the need for medications comes down with use of psychotherapy.
Lonazep being anti anxiety medication can help when you have the anxiety or you are not able to sleep but do not control any of the symptoms of OCD. Considering this fact taking it as needed basis is better strategy than the regular use.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Lonazep is not necessary
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query and understand your concerns.
First of all about your non response to Fluvoxamine due to following things.
1. Change in batch no. of medicines- No two batches of medicines are similar and it is possible that current batch of your medicine is not equivalent of previous dosages. This is more likely when you are on generic medicines. If this is the possibility shift to older batches or use the branded one rather than generic one. I am aware that there is drug control policy but no harm in checking this.
The second possibility is emergence of new stressor in recent months. When we are stressed the need for medication is higher. If this is the case there is need to deal the problem without delay.
The third possibility is that due to prolonged condition of OCD there are some changes in brain which make the drug less effective. In such scenario increase of dose helps and in my view your psychiatrist is right in increasing the dose to 250 mg a day.
There are some theories that with prolonged use SSRI becomes ineffective. There is no substance behind such theories but it is possible that due to one or another reason the theory is applicable for you.
Whatever the case I request you to enroll your self for psychotherapy along with medication. There is enough evidence to show that combination works better and the need for medications comes down with use of psychotherapy.
Lonazep being anti anxiety medication can help when you have the anxiety or you are not able to sleep but do not control any of the symptoms of OCD. Considering this fact taking it as needed basis is better strategy than the regular use.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for the suggestions..
Psychotherapy is associated with Psychiatrist or Psychologist..I mean should I consult a psychiatrist or a psychologist for the therapies? My psychiatrist has only suggested me 'tying and stretching rubber band on wrist' therapy ;that too dint prove any fruitful at the sessions of severe problem and panic attacks..
I also have severe body aches,especially in legs and my hands shiver a lot and I become nervous due to this..Is it because of my OCD/panic attacks or is it because my Vit D level is very low?
Psychotherapy is associated with Psychiatrist or Psychologist..I mean should I consult a psychiatrist or a psychologist for the therapies? My psychiatrist has only suggested me 'tying and stretching rubber band on wrist' therapy ;that too dint prove any fruitful at the sessions of severe problem and panic attacks..
I also have severe body aches,especially in legs and my hands shiver a lot and I become nervous due to this..Is it because of my OCD/panic attacks or is it because my Vit D level is very low?
Brief Answer:
psychologist will be better option
Detailed Answer:
Hello,
Thanksfor reverting back to me.
As youneed exposure and response prevention Behaviour therapy a psychologist will be better option.
The other symptoms described are classically due to Vitamin D deficiency rather than OCD. The current level is very low and you need immediate treatment in that regard.
I hope this helps you.
If you have any questions feel free to contact me.
Thanks and regards.
psychologist will be better option
Detailed Answer:
Hello,
Thanksfor reverting back to me.
As youneed exposure and response prevention Behaviour therapy a psychologist will be better option.
The other symptoms described are classically due to Vitamin D deficiency rather than OCD. The current level is very low and you need immediate treatment in that regard.
I hope this helps you.
If you have any questions feel free to contact me.
Thanks and regards.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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