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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Medication For Chronic Obsession

hello i am a chronic obssessed patient since 6years..and i am taking SSRIS since 6years like fluvoxamine(100mg) and clomipramine (25mg)..but still i dont find much effective in controlling my obssessions...only 50% is effective..s can you tell me which medicine is bes to control chronic obscessions..
Mon, 22 Sep 2014
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Psychiatrist 's  Response
hi... thanks for writing..i have understood your concerns..

so you were diagnose as a OCD patient before 6 years..what i feel here is the dosage of fluvoxamine and clomipramine is very low and ineffective...so you shud consult your psychiatrist and ask for increasing the dose of both these medications..with increase in dosage you will find further improvement..clomipramine can be increased to 225 to 300 mg in a day and fluvoxamine to 200 to 300 mg a day...

another option is to continue fluvoxamine and add fluoxetine, which is very effective in OCD.. fluoxetine also shud be taken in higher dosage like 80 mg in a day..

in my opinion, tell your concerns to your treating psychiatrist and ask for increase in the dosage..

i hope this advice will be helpful to you..best luck...

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Psychiatrist Dr. Jonas Sundarakumar's  Response
Hello and thanks for your query.

I understand that you are suffering from chronic Obsessive Compulsive Disorder (OCD) and have not got full relief with your medication.

In this case, I would recommend an increase in the dose of Fluvoxamine. Usually higher doses (100 tp 300 mg) are required to control obsessive symptoms.

If the maximal dose of Fluvoxamine is reached and still your symptoms are persisting, then the next option would be to change over to another medication such as Clomipramine (in adequate doses).

You can also consider the option of psychological therapy like CBT, in combination with medication, for better improvement.

Best wishes.
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Suggest Medication For Chronic Obsession

hi... thanks for writing..i have understood your concerns.. so you were diagnose as a OCD patient before 6 years..what i feel here is the dosage of fluvoxamine and clomipramine is very low and ineffective...so you shud consult your psychiatrist and ask for increasing the dose of both these medications..with increase in dosage you will find further improvement..clomipramine can be increased to 225 to 300 mg in a day and fluvoxamine to 200 to 300 mg a day... another option is to continue fluvoxamine and add fluoxetine, which is very effective in OCD.. fluoxetine also shud be taken in higher dosage like 80 mg in a day.. in my opinion, tell your concerns to your treating psychiatrist and ask for increase in the dosage.. i hope this advice will be helpful to you..best luck...