Brief Answer:
hike in clomipramine & clonazepam can help

Detailed Answer:
Hello,
You are on suitable meds for your OCD but not for bipolar (if you have that as well)...I think the obsession of looking out for gambling is a part of OCD only and not bipolrity.

You are taking clomipramine which is considered the drug of choice for OCD but should better be avoided in someone with high blood pressure. It is advisable to go for fluvoxamine instead. It is safe and effective at the same time.

So, if your blood pressure is controlled and not a very serious issue in itself & you were keeping fine on clomipramine prior to this relapse--then you may just increase the dosage of clomipramine.
You have not mentioend the dosages of any drug or I would have guided.

Secondly, you can reduce the concomitatnt anxiety fast by adding benzodiazapiens- during day time ( clonazepam) but donot drive or operate machinery as sedative efect of clonazepam might cause accident. You can take it in divided doses- thice a day.

Thirdly, you are taking lamotrigine, but, I cannot exactly put why you are taking that? To enhance effect of clomipraine? for this it is not a very suitable drug..

You can shift to oxcarbazepine. This drug is good, has little side effects and also effective in keeping check on bipolarity ( if it is there). Other options are not suitable or you as they have side effcts on heart or liver.

So, for now you may either increase clomipramine or add clonazepam thrice a day to tide over the crisis.

You may talk to your doctor about above points and shifting you to other drug combination if you want.

Also, please donot feel hopeless..relpases are common to psychiatric illness, but, they are controllable in almost all cases..just need to catch them in time & treat with right drugs.

Wish you good health & speedy recovery.
Please ask more queries to clarify doubts.
Dr. Manisha Gopal
MD Neuropsychiatry

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