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Suggest Treatment For Severe OCD While On Prozac
Question: hello-
i have asked questions to you before. I have harm ocd i actually the other day put a phone charger around my neck and pulled it then released it. it was like an urge i had to do. everyday from the moinute i wake up i get thoughts of setting myself on fire stabbing people and shooting with a gun. I have been taking prozac 80mg since december 5 i do not have any relief from the thoughts at all. how long does prozac take to work i also take latuda 80 mg for 4 months with no relief. the only thing that helps me is klonopin for sleep. i get urges images all of my waking hours. Does this sound like anyhing else to you
i have asked questions to you before. I have harm ocd i actually the other day put a phone charger around my neck and pulled it then released it. it was like an urge i had to do. everyday from the moinute i wake up i get thoughts of setting myself on fire stabbing people and shooting with a gun. I have been taking prozac 80mg since december 5 i do not have any relief from the thoughts at all. how long does prozac take to work i also take latuda 80 mg for 4 months with no relief. the only thing that helps me is klonopin for sleep. i get urges images all of my waking hours. Does this sound like anyhing else to you
Brief Answer:
its harm ocd only. doctor may change the drug if no relief comes in next 2w
Detailed Answer:
Hello,
Yes, I remember your history and that you have harm ocd with repetetive urges to hurt self and others.
The diagnosis is right, such symptoms occur in ocd and are very much treatable. The only main thing here is that drug takes more time to act. The usual waiting time for response in ocd case is around 6-8 weeks. So, you have some time left for the reponse to begin. Klonopin helps you in sleep. It is also used on "on and off" basis for treating strong urges and anxiety by me in many ocd cases.. The response is good but the drug should not be used daily for this purpose.
You may wait for two to three weeks more and if still there is no relief then you may visit your doctor.
When I have similar case of ocd which dosent show response to first drug then I shift the patient to some other medication like venalafaxine or clomipramine.
Same for latuda. If by the next visit there is no additional benefit, you may report this to your treating team. The medicine can be changed to something like quetiapine.
please have faith and patience. The desire to put wire around the neck was not good and it was not wise to act on it. You must curtail such thoughts. You can try ot do some other work at that time or change the place or room or just start talkimg to some ine...this would help. When ever such self harming thoughts take away your self control then you may take klonopin 0.25 mg.
wish you good luck and good health.
Please feel free to ask more questions for clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
its harm ocd only. doctor may change the drug if no relief comes in next 2w
Detailed Answer:
Hello,
Yes, I remember your history and that you have harm ocd with repetetive urges to hurt self and others.
The diagnosis is right, such symptoms occur in ocd and are very much treatable. The only main thing here is that drug takes more time to act. The usual waiting time for response in ocd case is around 6-8 weeks. So, you have some time left for the reponse to begin. Klonopin helps you in sleep. It is also used on "on and off" basis for treating strong urges and anxiety by me in many ocd cases.. The response is good but the drug should not be used daily for this purpose.
You may wait for two to three weeks more and if still there is no relief then you may visit your doctor.
When I have similar case of ocd which dosent show response to first drug then I shift the patient to some other medication like venalafaxine or clomipramine.
Same for latuda. If by the next visit there is no additional benefit, you may report this to your treating team. The medicine can be changed to something like quetiapine.
please have faith and patience. The desire to put wire around the neck was not good and it was not wise to act on it. You must curtail such thoughts. You can try ot do some other work at that time or change the place or room or just start talkimg to some ine...this would help. When ever such self harming thoughts take away your self control then you may take klonopin 0.25 mg.
wish you good luck and good health.
Please feel free to ask more questions for clarification.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
lorazepam may be tried
Detailed Answer:
Helo,
Klonopin is taken for reducing the anxiety associated with the repetetive urges and reduce the mental stress . It dosent help with the thoughts but will give more control and patience for them.
So, if klonopin dosent give you any relief in anxiety associated with the urges then it is useless for using in daytime.
But please see if it helps in calming you at a dosage less than what you take for sleeping, ( even though the thoughts are coming ) then it can be a good option for reducing the stress which trouble you all day long.
People dont act on such voilent urges mostly..please dont worry about this.
You may also try other benzodiazapines like lorazepam, for managing daytime anxiety ( if klonopin is not at all efefctive).
You may discuss this with your doctor as well in next visit..
Wish you a speedy recovery.
please ask further queries if there are more concerns.
Dr. Manisha Gopal
MD Neuropsychiatry
lorazepam may be tried
Detailed Answer:
Helo,
Klonopin is taken for reducing the anxiety associated with the repetetive urges and reduce the mental stress . It dosent help with the thoughts but will give more control and patience for them.
So, if klonopin dosent give you any relief in anxiety associated with the urges then it is useless for using in daytime.
But please see if it helps in calming you at a dosage less than what you take for sleeping, ( even though the thoughts are coming ) then it can be a good option for reducing the stress which trouble you all day long.
People dont act on such voilent urges mostly..please dont worry about this.
You may also try other benzodiazapines like lorazepam, for managing daytime anxiety ( if klonopin is not at all efefctive).
You may discuss this with your doctor as well in next visit..
Wish you a speedy recovery.
please ask further queries if there are more concerns.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
i always worry about acting on the violent urges how would i know if i was going to i never did that with the phone charger. i always think im gonna shoot or stab someone i dont have a gun it is just constantly in my head. do you think prozac is the right drug for these symptoms and will the thoughts decrease with it if not what else would i try
Brief Answer:
prozac is right; and so are comipramine venalafaxine or vilazodone
Detailed Answer:
Hello,
Thanks for writing back.
You are right in worrying about the possibility and fear of carrying out on your urges but really that dosent happen. The phone charger thing was not like stabbing so you just attempted it, but none of my patients had ever attempted anything serious under his or her urges. So, please have faith.
If any of my patients dosent have good improvement with prozac then I change to clomipramine or venalafaxine along with therapy.
It has almost always given me good response.
Vilazodone can also be tried, it is also very effective on anxiety as well.
So, prozac is definitely a right drug but there are other options as well for managing ocd.
Hope the reply is useful and informative for you.
Dr. Manisha Gopal
MD Neuropsychiatry
prozac is right; and so are comipramine venalafaxine or vilazodone
Detailed Answer:
Hello,
Thanks for writing back.
You are right in worrying about the possibility and fear of carrying out on your urges but really that dosent happen. The phone charger thing was not like stabbing so you just attempted it, but none of my patients had ever attempted anything serious under his or her urges. So, please have faith.
If any of my patients dosent have good improvement with prozac then I change to clomipramine or venalafaxine along with therapy.
It has almost always given me good response.
Vilazodone can also be tried, it is also very effective on anxiety as well.
So, prozac is definitely a right drug but there are other options as well for managing ocd.
Hope the reply is useful and informative for you.
Dr. Manisha Gopal
MD Neuropsychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
how do i control my urges to stab and shoot someone. it comes up in my mind naturally and i seem to have no control over my thoughts. it feels like i could possibily carry out the act. is there anything to prevent
Brief Answer:
only ways are medicines; keeping oneself busy and therapy
Detailed Answer:
Hello
I can very well understand your condition but im sorry to say that there is hardly any effective way to control the repetetive disturbing urges except medicines.
Had it been feasible to control them in other ways it would not have been taken up as a disorder in the first place.
So, take the medicines and may be try to be busy with one or the other works/ try to talk with someone or may be go out a little.
when you have some improvement in symptoms you may try exposure and response prevention therapy.
Its just the matter of time whenyou start having some effect from the drugs and then it dosent take much time in having good improvement.
Wish you all the best!
Dr. Manisha Gopal
MD Neuropsychiatry
only ways are medicines; keeping oneself busy and therapy
Detailed Answer:
Hello
I can very well understand your condition but im sorry to say that there is hardly any effective way to control the repetetive disturbing urges except medicines.
Had it been feasible to control them in other ways it would not have been taken up as a disorder in the first place.
So, take the medicines and may be try to be busy with one or the other works/ try to talk with someone or may be go out a little.
when you have some improvement in symptoms you may try exposure and response prevention therapy.
Its just the matter of time whenyou start having some effect from the drugs and then it dosent take much time in having good improvement.
Wish you all the best!
Dr. Manisha Gopal
MD Neuropsychiatry
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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