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Suggest Treatment For Anxiety, Brain Fog And Peripheral Neuropathy
Question: Hello Doctor,
I was diagnosed as OCPD in February, 2016. I had taken 20 mg of
Paxil for 21 years (1993-2014). It kept my ocd under control. Then
because of sexual side effects, I tapered off it with a doctor in
Sept. 2014. When I noticed the ocd symptoms returning, I reinstated 10
mg paxil in November 2015 but found it agitated me. I was hospitalized
in March, 2016 for 2 weeks with my ocd symptoms (obsessive expression
of anger) full on. While there, I was given 30 mg paxil plus 15 mg
mirtazapine. I was told by several doctors that the mirtazapine helps
with ocd. After being discharged, with my doctors permission, I
tapered down to 10 mg of paxil because it was too strong and then
increased the mirtazapine to 30 mg three weeks ago (May 10). The paxil
is aggravating me again. My ocd symptoms have improved but I am
concerned that it may be primarily because of the paxil. I was also given a week's worth of cipro, 500 mg 2x a day in July 2015 and am still experiencing side effects from that, brain fog, anxiety, and peripheral neuropathy.
My question is, will the 30 mg mirtazapine help my ocd if I taper
off the paxil completely? And if so, how long does it normally take? I
know it takes longer for a med to improve ocd.
Thank you,
XXXX
I was diagnosed as OCPD in February, 2016. I had taken 20 mg of
Paxil for 21 years (1993-2014). It kept my ocd under control. Then
because of sexual side effects, I tapered off it with a doctor in
Sept. 2014. When I noticed the ocd symptoms returning, I reinstated 10
mg paxil in November 2015 but found it agitated me. I was hospitalized
in March, 2016 for 2 weeks with my ocd symptoms (obsessive expression
of anger) full on. While there, I was given 30 mg paxil plus 15 mg
mirtazapine. I was told by several doctors that the mirtazapine helps
with ocd. After being discharged, with my doctors permission, I
tapered down to 10 mg of paxil because it was too strong and then
increased the mirtazapine to 30 mg three weeks ago (May 10). The paxil
is aggravating me again. My ocd symptoms have improved but I am
concerned that it may be primarily because of the paxil. I was also given a week's worth of cipro, 500 mg 2x a day in July 2015 and am still experiencing side effects from that, brain fog, anxiety, and peripheral neuropathy.
My question is, will the 30 mg mirtazapine help my ocd if I taper
off the paxil completely? And if so, how long does it normally take? I
know it takes longer for a med to improve ocd.
Thank you,
XXXX
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks for your question.
I do believe in your case it would be wise to taper off the Paxil completely. I would concurrently increase the mirtazapine to 45mg daily. Mirtazapine can indeed be effective for treating OCD, but it must be used at high doses. The dose of 30mg is not enough and will need to be increased. It may take 4-6 weeks for this increase in mirtazapine to reach full effect in treating your OCD symptoms. But I would expect it to get better!
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Consultation
Detailed Answer:
Hello, and thanks for your question.
I do believe in your case it would be wise to taper off the Paxil completely. I would concurrently increase the mirtazapine to 45mg daily. Mirtazapine can indeed be effective for treating OCD, but it must be used at high doses. The dose of 30mg is not enough and will need to be increased. It may take 4-6 weeks for this increase in mirtazapine to reach full effect in treating your OCD symptoms. But I would expect it to get better!
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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