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Question: hi i am saffaring mild OCD from past 3 years back doctors priscribed me nexito forte 20 mg from past 3 years gradualy i have reduced nexito forte 10 mg 1 year taken and 5 mg 6 month taken, 2 weeks back i live the tablet its again i have suffer anaxity and depreesion how to control pls help
Brief Answer:
please start nexito again to get well
Detailed Answer:
Hello,
OCD is a disorder which needs relatively long term treatment compared to anxiety and depressive illnesses. Even the medicines take longer time to bring good results in this illness and we (doctors) dont start reducing the medicine soon.
So, firstly, you should not have reduced and stop the mediicne on your own.
Its not very common that in OCD, patient has very good or complete response. So, if you had complete response you should ideally continue drugs for few years. It is a sort of long term course in which nerves get stabilised.
secondly, now when you have discontinued the drugs illness is coming back again.
I would advice you to restart the medicine. May be you can start with lower dosage strength and see how is the response. OCD is almost always accompanied with depression and anxiety problems --that is why you are having such symptoms again.
It is not possible to help OCD completely without medicines. You may however try relaxation exercises along with medicines. These help in bringing early response and less drugs are used.
Also, get TSH levels and Vit. B12 levels to rule out deficiency.
Hope the reply is useful for you. Please ask more questions for clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
please start nexito again to get well
Detailed Answer:
Hello,
OCD is a disorder which needs relatively long term treatment compared to anxiety and depressive illnesses. Even the medicines take longer time to bring good results in this illness and we (doctors) dont start reducing the medicine soon.
So, firstly, you should not have reduced and stop the mediicne on your own.
Its not very common that in OCD, patient has very good or complete response. So, if you had complete response you should ideally continue drugs for few years. It is a sort of long term course in which nerves get stabilised.
secondly, now when you have discontinued the drugs illness is coming back again.
I would advice you to restart the medicine. May be you can start with lower dosage strength and see how is the response. OCD is almost always accompanied with depression and anxiety problems --that is why you are having such symptoms again.
It is not possible to help OCD completely without medicines. You may however try relaxation exercises along with medicines. These help in bringing early response and less drugs are used.
Also, get TSH levels and Vit. B12 levels to rule out deficiency.
Hope the reply is useful for you. Please ask more questions for clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
i have alredy stop one month back i am going for CBT therepy now its reduce anaxity and depression the CBT therepist (psycayrtist) was told me dont take madichene i will prepaird if once start the Medicine how long time taken if i have taken the tablet can i marraige pls advice me
Brief Answer:
if results are good 6-9months
Detailed Answer:
Hello,
Therapy (CBT or ERP) along with medicines are best to manage OCD disorder. Please do continue with therapy. However, if you will add nexito the results would be better and quick.
From the past history you gave in query I can see that you have had good response to drugs earlier. So, I hope that within next 6-9months your illness should be under control and you can proceed in life. You can get married when ever you feel like once the acute phase of illness is controlled adequately. I think that 6-9 months should suffice( but there can be some variations).
Talk to your doctor about restarting meds and also discuss the marriage issue.
Wish you good health.
Dr. Manisha Gopal
MD Neuropsychiatry
if results are good 6-9months
Detailed Answer:
Hello,
Therapy (CBT or ERP) along with medicines are best to manage OCD disorder. Please do continue with therapy. However, if you will add nexito the results would be better and quick.
From the past history you gave in query I can see that you have had good response to drugs earlier. So, I hope that within next 6-9months your illness should be under control and you can proceed in life. You can get married when ever you feel like once the acute phase of illness is controlled adequately. I think that 6-9 months should suffice( but there can be some variations).
Talk to your doctor about restarting meds and also discuss the marriage issue.
Wish you good health.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Prasad
This med
We r taken life long r wt mam pls advice
We r taken life long r wt mam pls advice
Brief Answer:
i think we can try stopping drug once more
Detailed Answer:
Hello,
You said that you have been suffering from this illness from past 3-4yrs only and have had good response to medicnes last time -then Im hopeful that you will respond nicely this time too.
So, ideally when you get well now, we can try taper and stop medicine . But the point is that let the doctor do this in his or her way (according to the research); you should not play with the medicines. Had you not started reducing and stopped the drug on your own last time- may be you would have been keeping completely well presently on very less medicine.
Let go the past - start medicine and i think you would not need to take it for whole life.
Good luck.
Dr. Manisha Gopal
i think we can try stopping drug once more
Detailed Answer:
Hello,
You said that you have been suffering from this illness from past 3-4yrs only and have had good response to medicnes last time -then Im hopeful that you will respond nicely this time too.
So, ideally when you get well now, we can try taper and stop medicine . But the point is that let the doctor do this in his or her way (according to the research); you should not play with the medicines. Had you not started reducing and stopped the drug on your own last time- may be you would have been keeping completely well presently on very less medicine.
Let go the past - start medicine and i think you would not need to take it for whole life.
Good luck.
Dr. Manisha Gopal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
mam this tablets reduce sex issue ? this is only last chance r wt mam for living tablet? i have alredy fixed my marraige what i am do i have alredy started the madicene as per our pshycartist. and why am thinking about my illness every time,
befor i am not thinking this issue , it increase bady waigt how to reduce? if your knowledge how money year we have to take .and i am not consantratent my work pshycortist precicribed 10 mg after 10 days 20 mg its currect? and they was told me go for marraige not problem what i am do pls help me and why another physcartist told me live the tablet its a bad for doctor ethics pls ur like my sister pls advice mam
homeopathy medicine is use full for this illness? homeopathy doctors was told me its take life long tablet in alopathy but Homeopathy only one year its true? and how money pepoles suffering in this illness? some time fear is coming wt do mam.and other thing before 3 years back i have many time reduce and increasing the dose thats not a problem for prasent medichine one one time i think i discannect the marraige waht i am do tel me pls. i have alredy fix the marraige pls suggest me .
befor i am not thinking this issue , it increase bady waigt how to reduce? if your knowledge how money year we have to take .and i am not consantratent my work pshycortist precicribed 10 mg after 10 days 20 mg its currect? and they was told me go for marraige not problem what i am do pls help me and why another physcartist told me live the tablet its a bad for doctor ethics pls ur like my sister pls advice mam
homeopathy medicine is use full for this illness? homeopathy doctors was told me its take life long tablet in alopathy but Homeopathy only one year its true? and how money pepoles suffering in this illness? some time fear is coming wt do mam.and other thing before 3 years back i have many time reduce and increasing the dose thats not a problem for prasent medichine one one time i think i discannect the marraige waht i am do tel me pls. i have alredy fix the marraige pls suggest me .
Brief Answer:
start drug, get better and can marry
Detailed Answer:
Hello,
1. Start your medicine again and once you start feeling better and ocd is controlled you can proceed for marriage. Marriage is not a contraindiaction. Moreover, may be a good partner is able to take care of you in a better way.
2. There should not be any sexual problem as medicine is quite safe and mild. You have used it before and so you must be knowing its effect on your body..
3. Once you get well, continue the drug for some more time comapred to last attemp and follow your doctor advice in reducing or stopping it. Dont try doing it yourself next time.
4.I have never studied homeopathy so, I cant guide you on its treatment modality or anything related. You should ask someone educated in that field and decide for yourself.
You may talk to your family member and take thier advice.
5. One in every four individual suffer from mental illness and anxiety and ocd is one of the commonest mental illness. So, dont feel that you are alone or it is soemthing rare. It is quite common than you know.
6. Your current fears and anxiety are more due to recurring illness; it will hopefully settle down once you get back to nexito.
Wish you good luck.
please ask if there are anymore queries
Dr. Manisha Gopal
MD Neuropsychiatry
start drug, get better and can marry
Detailed Answer:
Hello,
1. Start your medicine again and once you start feeling better and ocd is controlled you can proceed for marriage. Marriage is not a contraindiaction. Moreover, may be a good partner is able to take care of you in a better way.
2. There should not be any sexual problem as medicine is quite safe and mild. You have used it before and so you must be knowing its effect on your body..
3. Once you get well, continue the drug for some more time comapred to last attemp and follow your doctor advice in reducing or stopping it. Dont try doing it yourself next time.
4.I have never studied homeopathy so, I cant guide you on its treatment modality or anything related. You should ask someone educated in that field and decide for yourself.
You may talk to your family member and take thier advice.
5. One in every four individual suffer from mental illness and anxiety and ocd is one of the commonest mental illness. So, dont feel that you are alone or it is soemthing rare. It is quite common than you know.
6. Your current fears and anxiety are more due to recurring illness; it will hopefully settle down once you get back to nexito.
Wish you good luck.
please ask if there are anymore queries
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
This is last chance r wt mam? Otherwise I have take life long wy this illness come wts the resion some people's write on net some side effect its currect r wt mam
Brief Answer:
focus in medicine not on sideeffects
Detailed Answer:
Hello,
The drug takes time to act and stabilise ocd illness. We usually want to keep the medicine as such for atleast one more year compared to last time of relapse.
According to the research - we usually try stopping the drug twice but if there is a third relapse - its better to continue the medicine.
I dont understnd what do you mean by last chance? Please tell clearly what you want to ask so that I can help.
The side effects of the drug which you are taking is hardly any. It is one of the safest and mildest drug used in psychiatry. Please dont worry so much; if you didnt have any problem with this medicine earlier- its unlikely you will have any further.
Dont read too much on net about the drugs yourself ; instead ask your doctor or someone qualified and see if you have any issue with it.
You should ideally be seeing internet that how therapy and drugs act and what diet etc and lifestyle changes can help you get over with illness fast. Its not that internet is all wrong about medicines but everyone never develop all side effects and reading them beforehand only adds to unnecessary stress and fear.
wish you speedy recovery!
Dr. Manisha Gopal
MD Neuropsychiatry
focus in medicine not on sideeffects
Detailed Answer:
Hello,
The drug takes time to act and stabilise ocd illness. We usually want to keep the medicine as such for atleast one more year compared to last time of relapse.
According to the research - we usually try stopping the drug twice but if there is a third relapse - its better to continue the medicine.
I dont understnd what do you mean by last chance? Please tell clearly what you want to ask so that I can help.
The side effects of the drug which you are taking is hardly any. It is one of the safest and mildest drug used in psychiatry. Please dont worry so much; if you didnt have any problem with this medicine earlier- its unlikely you will have any further.
Dont read too much on net about the drugs yourself ; instead ask your doctor or someone qualified and see if you have any issue with it.
You should ideally be seeing internet that how therapy and drugs act and what diet etc and lifestyle changes can help you get over with illness fast. Its not that internet is all wrong about medicines but everyone never develop all side effects and reading them beforehand only adds to unnecessary stress and fear.
wish you speedy recovery!
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Means I have stop 5 or 6 time without doctor advice hence in fiuture after taking long term medicine how mony times u trying about stop the medicine otherwise life long time pls tel me and this medicine incrising body waigt how to reduce plz tel me mam
Some times fear also coming before taking the medicine I have fully enjoy my life n is decreasing all interest and all n I am working accounts deportment.presently my finance issue is not good otherwise I go back my village for agricultarel work this medicine reduce the strength r wt mam . sum doctors told me this type of madicene u have take life long its tru r wt mam pls advice other wise I have stop my marriage pls advice me this is last qt mam
Some times fear also coming before taking the medicine I have fully enjoy my life n is decreasing all interest and all n I am working accounts deportment.presently my finance issue is not good otherwise I go back my village for agricultarel work this medicine reduce the strength r wt mam . sum doctors told me this type of madicene u have take life long its tru r wt mam pls advice other wise I have stop my marriage pls advice me this is last qt mam
Brief Answer:
eat wisely, avoid oily food & do gym
Detailed Answer:
Hello,
You have not done the right thing by stopping the medicines on your own so many times. Dont do so again even if you are 100% fine.
you can still get well again on medicines and I hope that we may try to stop drugs once but only after a long treatment duration. So, dont fear for lifelong drugs as of now.
Weight is not increased by drugs but by what we wat. Drug increase your need to eat- so keep a check on what you eat;
maintain healty diet; join a good gym; avoid sweets and high carbohydrate foods like - samosa etc, avoid oily food.
try to be more active. By these methods you wony gain weight with drug.
Hope the reply helps you.
Dr. Manisha Gopal
MD Neuropsychiatry
eat wisely, avoid oily food & do gym
Detailed Answer:
Hello,
You have not done the right thing by stopping the medicines on your own so many times. Dont do so again even if you are 100% fine.
you can still get well again on medicines and I hope that we may try to stop drugs once but only after a long treatment duration. So, dont fear for lifelong drugs as of now.
Weight is not increased by drugs but by what we wat. Drug increase your need to eat- so keep a check on what you eat;
maintain healty diet; join a good gym; avoid sweets and high carbohydrate foods like - samosa etc, avoid oily food.
try to be more active. By these methods you wony gain weight with drug.
Hope the reply helps you.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
madam i have start nexito 2 weeks back as per one of best psycartist ( Dr Palaksha) 42 years experieanse in XXXXXXX but still i am using nexito forte what is the diffrence between nexito and nixito forte tablet,and he was told go for marry this is not a problem like that.but old physcartist ( T.S XXXXXXX naran Rao) told me you started floxomine 50 mg & nexito forte 10 mg wich one is better? next month marraige is there what i am do i cont understand.sexueal i am weak now pls give me the sugesstion any time i am surching internet for in this illnes and comper to other pepole behavier pleas give the advise pls
Brief Answer:
go on with nexito for now, can marry
Detailed Answer:
Hello,
Fluvoxamine and nexito - both are good for treating OCD. As you have had good response to nexito in past, its better to stay on the same drug again as fluvoxamine is stronger comapred to nexito. Had there been no good response to nexito I would have recommended fluvoaxamine.
So, you may just stay on nexito for a while and see if it helps you again.
Nexito has only escitalopram while nexito-forte has escitalopram and clonazepam both. Escitalopram is anti OCD drug while clonazepam controls mild anxiety associated with OCD. It depends on the patient's symparoms; doctor's choice and experience if he wants to go ahead with one or the other. There is no major issue, both are almost same, dont worry.
Youe sexual weakness can be due to thought process of OCD itself or mild sadness . This is supposed to wean off with time, so I think you may proceed for marriage if you think that drug is able to handle OCD.
If sexual weakness persists then you should discuss this with your treating doctor and get it treated. But overall, I think it is manageable and will not pose any problem in your marital life.
Wish you speedy recovery.
Dr. Manisha Gopal
MD Neuropsychiatry
go on with nexito for now, can marry
Detailed Answer:
Hello,
Fluvoxamine and nexito - both are good for treating OCD. As you have had good response to nexito in past, its better to stay on the same drug again as fluvoxamine is stronger comapred to nexito. Had there been no good response to nexito I would have recommended fluvoaxamine.
So, you may just stay on nexito for a while and see if it helps you again.
Nexito has only escitalopram while nexito-forte has escitalopram and clonazepam both. Escitalopram is anti OCD drug while clonazepam controls mild anxiety associated with OCD. It depends on the patient's symparoms; doctor's choice and experience if he wants to go ahead with one or the other. There is no major issue, both are almost same, dont worry.
Youe sexual weakness can be due to thought process of OCD itself or mild sadness . This is supposed to wean off with time, so I think you may proceed for marriage if you think that drug is able to handle OCD.
If sexual weakness persists then you should discuss this with your treating doctor and get it treated. But overall, I think it is manageable and will not pose any problem in your marital life.
Wish you speedy recovery.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
madam you n this illnes curing pasent?and any time i am sarching about this illnes related issues in internet and i thinking i am not given sexueal satisfaction for my wife like that thoughts its come any time how to avodie ples give me the advice other wise i have to change my job pls sugest me
Brief Answer:
yes, I see such patients & dont read on net
Detailed Answer:
Hello,
OCD is a common mental illness and almost one in every four person suffers from this in general population. So, every psychiatrist has many such patients under them for treatment.
It is common for the patients
to search and read about their illness on internet these days. But if your worries increases due to this - its better that you stop reading anything related to it from net.
Your concrens about sexual weakness is also due to the obsessive thoughts of oCD.
So with advancement in treatment and as you will get better- this will get resolved.
Wish you good luck.
Dr. Manisha Gopal
MD Neuropsychiatry
yes, I see such patients & dont read on net
Detailed Answer:
Hello,
OCD is a common mental illness and almost one in every four person suffers from this in general population. So, every psychiatrist has many such patients under them for treatment.
It is common for the patients
to search and read about their illness on internet these days. But if your worries increases due to this - its better that you stop reading anything related to it from net.
Your concrens about sexual weakness is also due to the obsessive thoughts of oCD.
So with advancement in treatment and as you will get better- this will get resolved.
Wish you good luck.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
CBT therpist told me you take 10 mg nexito forte thats all dont take 20 mg he is also psycartist (Suddhir Hebbar) he is also in net i meet every week, bfore one month back i have taken only nexito 5 mg but that time i am not suffer from ocd when thy told me you live that tablet what hapen i will see like that told me ? why that ( physcartist) told me like that.and now again start the medicine one one time sucide thoughts also coming it is medicine effect or wt madam
one clarification recuired madam please tel me.
1) frends and me one time sexed with one lady, after two days one person told me you dont go like that HIV its coming like that told me after i geting fear every time i thinking that illnes after i have cheked so many time HIV test but it is negetive first time 6 month i am not sleep and eat very well
2) i went my village after my sister was dade then i am not feel i think Depression i get that time i dont no this is mind illness like that after viste psycartist he was given some tablets 1 week now i sleep beter grasuealy reduce my illnes after 2 years i am not think any mater very well sleep and ply valyball do some work in agriculture land that time i am fine.
3) after 2 years come back XXXXXXX for job one years my ocd illness not there in city, and one time its room frendis are there some time thouts coming my frends sexd with me like that just thats after not sleeping very well and then Lastly coming Fan fealt an my body like that thouts also coming it is OCD problem or what mam and then go for Psycartist and take tablet agine i have done big problem why i am going for psycartist for small ocd why i am not going for ( psycologist Like that) in this summary that time i have suffering from OCD or What ? when taking nexito forte tablet i am done very well work and enjoy my life from past 3 years when i live that tablet my illness is come back one one time after taking the long term tretment after also illness come back what i am like that thougts also coming prasently what i am do please sugest me .
one clarification recuired madam please tel me.
1) frends and me one time sexed with one lady, after two days one person told me you dont go like that HIV its coming like that told me after i geting fear every time i thinking that illnes after i have cheked so many time HIV test but it is negetive first time 6 month i am not sleep and eat very well
2) i went my village after my sister was dade then i am not feel i think Depression i get that time i dont no this is mind illness like that after viste psycartist he was given some tablets 1 week now i sleep beter grasuealy reduce my illnes after 2 years i am not think any mater very well sleep and ply valyball do some work in agriculture land that time i am fine.
3) after 2 years come back XXXXXXX for job one years my ocd illness not there in city, and one time its room frendis are there some time thouts coming my frends sexd with me like that just thats after not sleeping very well and then Lastly coming Fan fealt an my body like that thouts also coming it is OCD problem or what mam and then go for Psycartist and take tablet agine i have done big problem why i am going for psycartist for small ocd why i am not going for ( psycologist Like that) in this summary that time i have suffering from OCD or What ? when taking nexito forte tablet i am done very well work and enjoy my life from past 3 years when i live that tablet my illness is come back one one time after taking the long term tretment after also illness come back what i am like that thougts also coming prasently what i am do please sugest me .
Brief Answer:
take treatment with one doctor & dont read net
Detailed Answer:
Hello,
It is difficult to comment as to why the other psychiatrist on net asked you to take lesser dosage. I think you should ask him for the reason( because this is both your right and also his duty to explain). I cant answer it correctly because I didn't have any role in it.
If suicidal thoughts are coming then I think that you must discuss them with your therapist and may be he would increase the dosage and therapy sessions.
1. If you have got yourself checked for HIV several times in 6 months and they are normal then your doubts are just part of OCD . I hope they will subside with treatment. Its ok to be fearful of such illness but don't let it bother you a lot. You are HIV negative and that is final. Don't do unprotected sex with stranger again. Always go for protection.
2.You are right that working in farm etc., helps you. Exercise helps mental illness, try to go for regular walks or join a gym to get better response.
3. Sexual practice with anyone does not cause OCD, this is a separate illness. You were fine with nexito forte but because you stopped it on your own you had a relapse. Just do as your doctor says and you will again become good.
Try to take treatment with one psychiatrist and do not go to many --as this will just add to confusion.
Also abstain from reading about drugs or illness on net.
Wish you speedy recovery.
Dr. Manisha Gopal
MD Neuropsychiatry
take treatment with one doctor & dont read net
Detailed Answer:
Hello,
It is difficult to comment as to why the other psychiatrist on net asked you to take lesser dosage. I think you should ask him for the reason( because this is both your right and also his duty to explain). I cant answer it correctly because I didn't have any role in it.
If suicidal thoughts are coming then I think that you must discuss them with your therapist and may be he would increase the dosage and therapy sessions.
1. If you have got yourself checked for HIV several times in 6 months and they are normal then your doubts are just part of OCD . I hope they will subside with treatment. Its ok to be fearful of such illness but don't let it bother you a lot. You are HIV negative and that is final. Don't do unprotected sex with stranger again. Always go for protection.
2.You are right that working in farm etc., helps you. Exercise helps mental illness, try to go for regular walks or join a gym to get better response.
3. Sexual practice with anyone does not cause OCD, this is a separate illness. You were fine with nexito forte but because you stopped it on your own you had a relapse. Just do as your doctor says and you will again become good.
Try to take treatment with one psychiatrist and do not go to many --as this will just add to confusion.
Also abstain from reading about drugs or illness on net.
Wish you speedy recovery.
Dr. Manisha Gopal
MD Neuropsychiatry
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Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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