I have been taking Clomipramine for OCD for years, as well as Xanax for anxiety and Triazolam for insomnia. In the last year, the obsessive rituals have gotten worse, as well as the internal dialogue, the near-agoraphobia. Recently, my -- highly respected -- psychiatrist added SAD, GAD and clinical depression to his OCD diagnosis. Rather than replace the Clomipramine, which he says is among the best, he prescribed Gabapentin as an add-on (I cannot afford new drugs like Abilify.) The vicious cycle of sleep deprivation worsening the anxiety which worsens the rituals and so on is truly becoming unbearable. My doctor approves of my research and understanding of my disorders and available treatments. If I were your patient, would you recommend different medications(s)? Please keep in mind that I am woefully underinsured, so old-school is more reasonable financially for me.