![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 139. This is the beginning of the thread.
Posted by Bill82 on January 30, 2015, at 20:56:23
This will be a large post, but given as I am desperate for help and relief I hope it is ok, and I hope you will read it because I honestly need input. As this is my first post I will also introduce myself. My name is Bill82, and I am a 20 year old male who has extreme Sexual/Violent Ocd. My story starts about a year and a half ago in the summer of 2013. At the time I really wanted to enlist after college, and was really scared of anything that could jeopardize my dreams and goals in the military. One such obstacle that I face was the dreaded medical dq you experience at MEPS(Military Entrance and Processing). Subsequently I started to overly attend and worry about my health and how i could be dqed. As a compulsion I researched for reassurance. However, this was the period of time when my research became obsessive, and I seemingly couldn't shake off the "what if". Life went on and I went back to school in the fall, and things quited down. However, I had my first sexual experience and subsequently became deathly afraid I had aquired HIV, Herpes, or would father a child(Even though I used protection, I was also drunk at the time). Thsi became worse and worse, yet I continued to excels at school. A month later I had onset of mycoplasma pneumonia(which has a dormancy of around 1 month and requires bodily contact to acquire). I had a high fever of 104 for several days and my OCD exploded and I no longer felt normal. OCD before this was breif what ifs that lasted a minute and I could brush off for days, now it was constant and terrifying. I subsequently came home from school and continued to deteriorate with a number of obsessions(that I now look back on saying wtf?) until I was disabled and hosue bound and in constant terror with sexual and violent obbsessions. I have tried CBT exp and honestly cannot do it, as I become not only suicidal and depressed but more worried and anxious. I have been to Mclean OCDI institute and failed. As for medication, which I am hoping can provide me some stability before this disease gets the best of me, I have tried many and am on my last legs so to speak in terms of finding help. I will now list reactions and effects of each medicine I Have tried.
Benzos:
-Lorazapam-drunken worried state, drug seeking behavior, grandiose planning, drug overdose
-Klonopin-same thing
-Valium-Same thing
Also experience extreme withdraws after each.Serotinergic Drugs-
-Mirtazipine-violent rages and sudden weight gain
-Prozac-Rash, inability to urinate, extreme anxious state(could be benzo withdrawl), vocal tic onset(went away after discontinuing), Impotence
-Luvox-Priapism, extreme sadness,emotional, apathy, reclusive, vivid dreams, Impotence, vocal tic
-Paxil-(when younger for anxiety) induced Hand washing within 3 days, after stopping never came back
-Zoloft- akethsia, Impotence, agitation/anxiety
-Lexapro- Impotence, increased sadness and OCD vocal tic
-Cymbalta-vocal tic, extreme stupor, extreme anxiety, Impotence
-Brintellix-Urinary Incontinence, Impotence, Depression, extreme vocal tics(longest one I have been on 4 months) Dumbness/ memory loss that persists
-Ondansetron-no side effects, but 2 months worth didn't do anything
-Buspar-brain zapsAnti psychotics
-Abilify- akeasthia, stomach pain, worsened ocd
-Risperidone- drooling, violent rages, extreme dumbnessGlutamatergic
-Memantine-Urinary Incontinence,Extreme Impotence, took for over two months at 20mg and saw no benefit
-Lamictal-apathy(could tell me my house burned down and I would say ok) and subsequently worsened ocdFolic Acid-
-Deplin- induces a severe depression after 2-4 hours after dosing. Repeatable and dont believe to be placebo, as each time I redosed I blew it off as placebo and it happened again. Bad enough depression to make me go seek out alchohal to drink it away,
Other notes
-Initially smoking ciggarettes made me feel great and I got high off them. This gradually went away until nothing happened. I subsequently quit about 3/4 a pack a day smoking for 4 months with no problem(Have read studies that say this is relevant to ocd)
-Alchohal obliterates my ocd and I feel confident again and my fears disapear, except I am drunk. My father was also an ex alcoholic, and every time I drink I usually black out, so I have been trying not to drink at all. Ocd extreme the next day too.
-Currently receiving IVIG treatment to possibly rule out PANDAS or PANS. Currently receiving 2g/kg each month. Has been 2 months. Was told I would see results in 8-9 months.
-Marijuanna severely worsens ocd, until I become apathetic to everything in which case I just dont do anything, I dont smoke marijuana, have only experimented.
-Morphine I received in hospital greatly reduced ocd....but we know where that leads, also ocd became extreme after stopping my prescribed percocets was terribleAbout if, overall, my ocd is extreme, and I dont know where to turn and neither do my drs. I have not tried clomipramine as I already get anticholinergic side effects from ssris so I can only imagine with that stuff. Also as my OCD revolves around sex, having good sexual health and ability to me is important, otherwise my ocd explodes and I will be in the shower for 4 hours till I bleed where the sun dont shine...
Anyone have any ideas or at least thoughts of encouragements, I for the first time in my life am starting to feel hopeless, and am starting to believe I wont make it out of this alive.
Posted by ed_uk2010 on January 31, 2015, at 12:22:49
In reply to OCD Dont know where to go, posted by Bill82 on January 30, 2015, at 20:56:23
Hi Bill,
It all sounds like a nightmare. I do have a few suggestions which you might potentially be interested in.
Possible options:
N-acetylcysteine capsules.
N-acetylcysteine has mainly been used as a add on to SSRIs, but may be effective alone.
Small trial (in treatment refractory pts) but.... "Of the patients in the N-acetylcysteine group, 52.6% were full responders at the end of the study, which was significantly higher than 15% of the patients in the placebo group."
http://www.ncbi.nlm.nih.gov/pubmed/23131885
N-acetylcysteine is of potential benefit in various forms of impulsive behavior.... OCD, skin picking, hair pulling, pathological gambling etc.
Pregabalin capsules.
Pregabalin has been used for various anxiety disorders, mainly GAD, for which is it approved in some countries. Very small studies suggest that it may be useful in OCD. (If stopping, pregabalin must be tapered slowly to prevent withdrawal symptoms).
http://www.ncbi.nlm.nih.gov/pubmed/21460732
Saffron. Saffron has been effective in animal models of OCD, but has not been studied for this purpose in humans. Several trials have demonstrated saffron to be effective against depression in humans, at a dose of 15mg of extract, twice a day. Perhaps you could try a similar dose for your OCD? Saffron has been shown to improve sexual function in some studies.
Posted by ed_uk2010 on January 31, 2015, at 12:25:50
In reply to OCD Dont know where to go, posted by Bill82 on January 30, 2015, at 20:56:23
I was meaning to ask, do you ever suffer from tics when not on SSRIs?
Posted by Bill82 on January 31, 2015, at 16:03:55
In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on January 31, 2015, at 12:25:50
Hi and thanks for the reply. I am currently on nac at 2600mg a day split into two doses so I hope it will help. I was about to try pregabalin but p doc decided against it die to adverse reactions to other GABA meds(benzos and lamictal). As for tics the best of my recollection is I do not have them off ssris. Occasionally I will get a small one when in public and very stressed, but this is always just a small motor tic of my head, and happens very infrequently when off ssri.
Posted by ed_uk2010 on January 31, 2015, at 18:00:27
In reply to Re: OCD Dont know where to go, posted by Bill82 on January 31, 2015, at 16:03:55
>I am currently on nac at 2600mg a day split into two doses so I hope it will help.
Have you just started it? Hope it helps.
>I was about to try pregabalin but p doc decided against it due to adverse reactions to other GABA meds (benzos and lamictal).
Pregabalin isn't at all similar to Lamictal. The fact that they're both used to treat focal epilepsy is essentially where the similarity ends.
Pregabalin has similarities and differences to benzos. Both can produce a 'drunk' feeling in some cases. Both tend to be associated with withdrawal symptoms. But they aren't the same, that's for sure.
>As for tics the best of my recollection is I do not have them off ssris.
RE antipsychotics. Have you ever taken a relatively selective dopamine D2 antagonist such as haloperidol or pimozide? Haloperidol is often poorly tolerated except at very low doses but your response (or lack of response) to this type of drug would potentially give a clue as to the underlying biology of your OCD, which could influence further treatment choices. You would need to be very cautious with the dose to avoid akathisia, if you did try it. Pimozide seems to cause slightly less EPS than haloperidol; it does need a pretreatment EKG and very cautious dose adjustment. Abilify and Risperdal hit so many receptors it's difficult to know what caused what..... As for the antipsychotic Zyprexa, it can sometimes worsen OCD - possibly by blocking serotonin 5-HT6 receptors.
>Occasionally I will get a small one when in public and very stressed, but this is always just a small motor tic of my head, and happens very infrequently when off ssri.
Since you've experienced tics, it might be useful to find out if your OCD responds to tic-suppressing drugs eg. haloperidol, pimozide, and the anti-adrenergics guanfacine and clonidine. OCD associated with tics may be a specific subtype (and poorly responsive to SSRIs), although I recognise that you don't experience many tics in the absence of aggravating medication. In Europe, sulpiride is a dopamine antagonist effective against tics and related behaviours. It's licensed as an antipsychotic and has a low to moderate risk of EPS. It's not available in the US.
Hope this gives you some ideas.
Posted by Bill82 on January 31, 2015, at 19:05:46
In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on January 31, 2015, at 18:00:27
Yea I have pondered going deeper into the antipsychotic realm but also am not certain what to do with the fact that they often are not poorly tolerated for long term. At my time at mclean hospital, I saw many others with ocd, some worse than I. I also saw the effects of what antipsychotic medications can do(shakes weight gain memory non existent) and quite honestly feel as if my life got any worse I couldn't handle it. And while d2 antagonists are effective for tics, I am not sure how helpful they are for ocd, which is my chief complaint, as even when my ticks are at their worse they don't bother me even when i shout in public. I will definitly look into the saffron, from my reading it looks like the extract used in most studies is similar to a component of tylenol, so I'll be weary of liver side effects. Other than that I guess I could talk about pregabalin again, but when I mean I had a problem in benzos and od I mean I took one, became drug seeking, yelled at people, then found them and just kept taking them till I blacked out, so maybe that's why she got scared off. Other thoughts I had were amantadine, because of both nmda and maybe borna disease if that was the case, but more for the nmda, riluzole, but not sure it would do anything as monotherapy, or possibly nefazadone, but not sure I could handle more memory loss than I already have haha. Anyways hope I didn't write too much
Posted by Bill82 on January 31, 2015, at 23:49:46
In reply to Re: OCD Dont know where to go, posted by Bill82 on January 31, 2015, at 19:05:46
Also was looking at the new drug pimavanserin possibly when it comes out in 2015, might be tough to get though, any input on what that might do? If anything guess it's something to keep my spirits up
Posted by ed_uk2010 on February 1, 2015, at 8:46:56
In reply to Re: OCD Dont know where to go, posted by Bill82 on January 31, 2015, at 19:05:46
>And while d2 antagonists are effective for tics, I am not sure how helpful they are for ocd, which is my chief complaint
They don't seem too useful for most people with OCD, but a subset do appear to respond. Long term side effects are certainly a major concern. D2 antagonist can potentially be used 'when required' for exacerbations in those who do respond, so that's something to consider. Some people find them useful for acute agitation. Again, you'd need to be cautious with the dose because too much can cause akathisia and more agitation. Those with OCD are generally less tolerant of antipsychotics than people with psychotic disorders. If you were to find something which provided at least partial or temporary relief, do you think you could undergo CBT with benefit?
In terms of the few antipsychotics which cause little or no EPS, have you tried Seroquel? I imagine you'd find it quite sedating but it is worthy of consideration.
What effect, if anything, did Risperdal have on your OCD? I know it wasn't tolerable, but did it affect your OCD?
>I will definitly look into the saffron, from my reading it looks like the extract used in most studies is similar to a component of tylenol, so I'll be weary of liver side effects.
I'm not sure what you mean about it being similar to a component of Tylenol. Studies using 15mg extract twice a day have shown good tolerability. Reported side effects in a minority include headache and nausea. Studies using double this dose (30mg extract twice a day) have shown evidence of decreased haemoglobin levels after long-term treatment. It seems best not to use the higher dose long-term. Of course, some countries use a lot of saffron in food, for colour and flavour, and I've not heard any mention of liver damage. Massive acute overdoses can cause bleeding, but there's no way you'd be taking anything like that much. Adding saffron to SSRIs seems to improve erectile function. On its own, it doesn't have much effect on sexual function... or so it seems.
>Other than that I guess I could talk about pregabalin again, but when I mean I had a problem in benzos and od I mean I took one, became drug seeking, yelled at people, then found them and just kept taking them till I blacked out, so maybe that's why she got scared off.
Pregabalin does have potential for misuse. It doesn't sound ideal for you to be quite honest.
>Other thoughts I had were amantadine, because of both nmda and....
You've tried the related memantine. Amantadine is similar but possibly more dopaminergic. I don't think it's the best choice for you right now.
>riluzole, but not sure it would do anything as monotherapy
It might, but is it affordable? If so, it could be something to try soon. It's generic here and much less expensive than it was. What's the situation with insurance coverage?
>Anyways hope I didn't write too much
Not at all.
>pimavanserin
I'm unsure whether this drug will be marketed. It might be. It sounds like something which would be used to augment other treatments.
>nefazodone
Now that it's little used due to liver issues... have you tried the related vilazodone? You might find vilazodone similar to vortioxetine, but it's difficult to say. Vilazodone binds to fewer receptors. It's mainly a serotonin reuptake inhibitor which also stimulates 5-HT1a receptors. I think it's fairly clear that you experience an unusually high incidence of side effects with serotonin reuptake inhibitors. This may be, in some ways, related to your age. People under 25 appear to experience considerably more psychiatric adverse effects to SRIs than older ppl.
Take care.
Posted by ed_uk2010 on February 1, 2015, at 9:00:36
In reply to OCD Dont know where to go, posted by Bill82 on January 30, 2015, at 20:56:23
>Initially smoking cigarettes made me feel great and I got high off them.
So, did you have OCD at this time? And did smoking affect your OCD?
Posted by Bill82 on February 1, 2015, at 9:32:05
In reply to Re: OCD Dont know where to go » Bill82, posted by ed_uk2010 on February 1, 2015, at 9:00:36
Yea I will have to inquire about amantadine and possibly riluzole. Another potential I just remembered is high dose glycine along with sacrosine, and if that does anything maybe try to get into the trial rote glyx13 they have going on here for ocd. And as for the saffron I thought I saw the extract that has effect, Corocins, are similar to tylenol it acetometiphine, I even think tylenol named crocin in India or something, but regardless tylenol is anti inflamitory and therefore might help. And no have not tried vilazadone as I am weary. I could probably try it, but the urinary incontinece made a huge mess every time I went, and even as I am disabled and can't do much, having urine drips all the time is just not worth the benifit haha. Anyways I have tried cbt and as for the erp I could not do it, as essentially the main component of agreeing with the thoughts I cannot do(have tried). Everything else about it I actually do in my rituals. I replay bad thoughts over and over till I feel ok they wernt what I first thought. But might be good to find someone to talk to I guess. As for cigarretes I started a couple days after my dr dropped me cause of benzos , I was scared and worried as I now had no drs, too young to buy a bottle, so I bought a pack of marlboro reds, significantly increased mood and my hope, didn't help ocd much but I was so high I didn't get as bothered by it. Smoked a whole pack in 4 hours. Now smoking dosnt do much of anything anymore, so I just stopped and didn't even have withdrawls which was weird
Posted by ed_uk2010 on February 1, 2015, at 10:07:33
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 9:32:05
Hello,
>And as for the saffron I thought I saw the extract that has effect, Corocins, are similar to tylenol it acetometiphine, I even think tylenol named crocin in India or something
About saffron. Saffron contains a yellow pigment called crocin. Crocin in saffron is in no way chemically related to acetaminophen/paracetamol (Tylenol).
Crocin is, as it happens, is a brand name for Tylenol in India, but this is nothing to do with the crocin compound in Saffron, it's just a coincidence of naming.
>And no have not tried vilazadone as I am weary. I could probably try it, but the urinary incontinece made a huge mess every time I went, and even as I am disabled and can't do much, having urine drips all the time is just not worth the benifit haha.
What was the incontinence like? A sudden urge to go? Occasional dripping? Do you have another condition which contributes to urinary problems, and have you seen a urologist about this?
Posted by Bill82 on February 1, 2015, at 10:17:57
In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 10:07:33
It was just after going I couldn't get it all out I guess, so I would feel all done stand up and it would keep dripping for a little bit. I have never had this in my life and it went away as soon as I stopped.
Neat about the saffron too, didn't put those two together, maybe I'll give it a go, you'd recommend 30mg a day or 15mg?
Posted by ed_uk2010 on February 1, 2015, at 12:56:53
In reply to OCD Dont know where to go, posted by Bill82 on January 30, 2015, at 20:56:23
>It was just after going I couldn't get it all out I guess, so I would feel all done stand up and it would keep dripping for a little bit. I have never had this in my life and it went away as soon as I stopped.
I'm surprised you had that effect with SSRIs. Urinary effects are much more likely with SNRIs like Cymbalta. The urinary effects of SNRIs and NRIs seem to be relieved by low doses of alpha blockers such as doxazosin, which improve urinary flow in men.
What were the urinary effects of memantine like?
>Neat about the saffron too, didn't put those two together, maybe I'll give it a go, you'd recommend 30mg a day or 15mg?
The recommended dose is 30mg of extract per day in total, divided into two doses of 15mg each.
>Zoloft- akathisia, impotence, agitation/anxiety etc...
Given your extreme reaction to SSRIs, have you ever tried a much lower than average dose? If so, what happened?
....for example, with sertraline (Zoloft), what would happen if you only took 1/4 of a 50mg tablet? Your adverse reactions to these drugs seems much more dramatic than expected. Which produced the most severe side effects for you, and which produced the mildest? And at what doses?
It is common for SSRIs to produce an initial aggravation of anxiety and sometimes OCD, but this is usually followed by a decrease. I'm surprised you managed to stay on Brintellix so long when the side effects were so bad. How long did you take the various SSRIs for?
Posted by Bill82 on February 1, 2015, at 13:10:41
In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 12:56:53
Zoloft was at 50mg for 3 days haha. And memantine was the same as brintillex, in that I dripped. As for brintillix I was only on 10mg and those were the side effects I got, as for how I stayed with it, I'm pretty desperate so I white knuckled it. I tested positive for a mtfhr gene mutation which is linked to extreme sensitivity to substances. Also just got a DNA test done too so maybe that will tell me something. Maybe this also explains why I got high as a kite off ciggarretes too haha. Prozac was 10 or 20ng, not sure and I got the allergic reaction. Luvox I think was 100 and I was a vegtable got there very slowly by tapering up from 12.5mg. I had also read that about ssri and was surprised, as I get primarily anticholinergic se from them like memory loss, and on prozac I could not urinate at all, so not sure why those other ones did that
Posted by ed_uk2010 on February 1, 2015, at 13:12:30
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 10:17:57
I've been wondering whether you are a 'slow metaboliser' of certain medications due to inherited deficiencies affecting specific drug metabolising enzymes in the liver. This may affect dosage requirements for some medications. No doubt, this isn't the only potential problem affecting your medication response, but it could be a contributing factor.
Around 6-8% of Caucasians have poor function of the enzyme CYP 2D6. This may affect drug levels of Prozac and many other psychiatric drugs.
Do you take any medication other than psychiatric medication at all? Or any herbal medicines? Do you drink grapefruit juice? (enzyme inhibitor, esp. CYP 3A4)
Posted by Bill82 on February 1, 2015, at 13:53:32
In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 13:12:30
At the moment on some antibiotics for a positive test for babes is and bartonella but when I took them I was just on vitamin pill, maybe a probiotic? Don't drink grapefruit juice either. Am Caucasian though, and I will get the DNA tests hopefully tomorrow. Don't smoke cigs anymore and don't smoke pot either, so liver is probably clean in that regard. Main problem with seritonergi a for me is they make me extremely spacy and slow, so much I'll go out to eat and just stare at the menu until the waiter comes and just then realize I'm in a restuarant haha.
Posted by ed_uk2010 on February 1, 2015, at 13:56:27
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 13:10:41
Hi,
>I tested positive for a MTFHR gene mutation....
Was this done because you were found to have elevated homocysteine levels, or perhaps because you have a family history of cardiovascular disease? I believe mutations are common in people with psych problems too. It's not a particular common test to have though. I suppose you will have seen quite a few different specialists.
I know you don't respond well to Deplin. I assume you've had your folate and B12 levels measured and any deficiencies corrected?
Do you know how you respond to supplements of folic acid, vitamin B12 and vitamin B6 (pyridoxine)?>Also just got a DNA test done too so maybe that will tell me something.
What have you been tested for? CYP 2D6 status?
>Zoloft was at 50mg for 3 days haha.
Clearly, you can't take Prozac again since you seem to be allergic. And Luvox produced some bad reactions.... so you won't be going there again.
So, Zoloft 50mg made you agitated?
>I get primarily anticholinergic se from them like memory loss
'Anticholinergic' means a drug which blocks muscarinic acetylcholine receptors. Although some of the side effects you've experienced sound superficially similar to certain anticholinergic symptoms, none of the drugs you've taken are strongly anticholinergic and most are not anticholinergic at all. Memantine is not thought to be anticholinergic - your side effects are presumably occurring via a different mechanism. There are many different neurotransmitters and processes involved in memory other than acetylcholine. In addition, norepinephine plays a major role in the urinary tract.
Potent anticholinergic drugs such as tolterodine and oxybutynin have the effect of relaxing the bladder muscle and reducing the urge to urinate. These drugs are used to treat urge incontinence. They do not generally cause dribbling. Dribbling is most common in older men, due to prostate disease, but can occur in younger men due to drugs which constrict the bladder outlet. SNRIs, NRIs and stimulants can do this, via indirect alpha adrenergic receptor stimulation.
It's not clear to me by what mechanism Prozac would cause urinary retention. It's anticholinergic effect is so weak as to be irrelevant, so there must be another cause. It is a very weak NRI, but that doesn't seem a likely cause either. It's confusing.
What were the urinary effects of the SNRI Cymbalta for you?
Posted by ed_uk2010 on February 1, 2015, at 13:59:53
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 13:53:32
>At the moment on some antibiotics for a positive test for babes is and bartonella but when I took them I was just on vitamin pill, maybe a probiotic? Don't drink grapefruit juice either.
Ah right. I was mainly checking because some meds are potent enzyme inhibitors and can therefore potentiate a variety of different drugs.
>Am Caucasian though, and I will get the DNA tests hopefully tomorrow.
How long will the results take?
>Main problem with seritonergi a for me is they make me extremely spacy and slow, so much I'll go out to eat and just stare at the menu until the waiter comes and just then realize I'm in a restuarant haha.
This isn't an anticholinergic effect. It must be to do with the increased serotonin causing overstimulation of certain serotonin receptors, producing cognitive dysfunction.
Would you be up for trialling a much lower dose? eg. sertraline (Zoloft) 12.5mg/day?
Posted by Bill82 on February 1, 2015, at 14:01:23
In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 13:12:30
At the moment on some antibiotics for a positive test for babes is and bartonella but when I took them I was just on vitamin pill, maybe a probiotic? Don't drink grapefruit juice either. Am Caucasian though, and I will get the DNA tests hopefully tomorrow. Don't smoke cigs anymore and don't smoke pot either, so liver is probably clean in that regard. Main problem with seritonergi a for me is they make me extremely spacy and slow, so much I'll go out to eat and just stare at the menu until the waiter comes and just then realize I'm in a restuarant haha.
Posted by ed_uk2010 on February 1, 2015, at 14:20:56
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 14:01:23
>At the moment on some antibiotics for a positive test for babes is and bartonella
Do you have any clinical signs of infection at the moment? Or it is a case of positive antibody tests suggesting past exposure?
Given the appearance of symptoms during a mycoplasma illness, I was wondering whether long-term antibiotic treatment to prevent a similar episode might be appropriate, for example with doxycycline.
Posted by Bill82 on February 1, 2015, at 14:51:22
In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 14:20:56
Yea it had both igm tests positive and still have very high miycoplasma titers that are slowly coming down. It might be a thought, currently on minocycline which is a glutamete reuptake enhancer, and I think it might help a little but maybe just placebo. Also of note I had trialled memantine twice before without adverse effects but now that I tried minocycline I got the side effects. Also low dose sertraline is a thought but it caused pretty bad agitation and restlessness had to move, heart rate at 110bpm sitting etc. I should hopefully get all the results tomorrow, they tested for all common genetic causes of adverse reactions to psych meds I beleive. The mtfhr was done without my knowledge actually, just saw I was tested and was positive. Vitamin b usually dosnt do all that much that I can tell, tried high dose inositol and only got extreme explosive diahrea, kept with it but didn't notice any benifit. Now that I think about it memeory is probably something than anticholinergic even though as I don't get dry mouth very bad, except a little on luvox but it didn't bother me.
Posted by ed_uk2010 on February 1, 2015, at 15:02:28
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 14:51:22
>....on minocycline which is a glutamate reuptake enhancer, and I think it might help a little but maybe just placebo.
I suppose the main benefit will be to help prevent re-infection. Hopefully, in the absence of further infections your symptoms will improve substantially over time.
>low dose sertraline is a thought but it caused pretty bad agitation and restlessness had to move, heart rate at 110bpm sitting etc.
I think you're a risk for severe side effects with all SSRIs at standard doses. The side effects are dose-dependent though.
Did you get any agitation on Lexapro?
>I should hopefully get all the results tomorrow, they tested for all common genetic causes of adverse reactions to psych meds I believe.
Let us know the results.
>Risperidone
The side effects you experienced sound fairly severe. What dose were you taking and how did it affect your OCD? Did you take it alone or in combination with an SSRI?
Posted by Bill82 on February 1, 2015, at 15:15:30
In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 15:02:28
Risperidone was lowest dose possible then cut in half and it caused severe rage/anger mixed with extreme drowsiness and depression, also did squat for ocd sadly. As for lexapro really bad impotence haha was extreme but the main reason I stopped was it like brintillex induced depression, which I normally don't have, just got ocd, and I will it might be two weeks now that I think if it but I will definitly post. Was just reading a new drug for depression that acts on opiate receptors, you heard of it? It's a combo of two medicines, bupreniphone and samidorphan I believe
Posted by ed_uk2010 on February 1, 2015, at 15:33:51
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 15:15:30
Well, I can see why you'd be reluctant to try SSRIs again, but I do think it might be worth trying a much lower dose... of Lexapro or Zoloft. Since you are very sensitive to the toxicity of these drugs for whatever reason, it is possible that a very low dose may turn out to be therapeutic. Whatever standard doses are doing, it's not what you need.
You could consider Lexapro, 2.5mg/day initially, then 5mg after a couple of weeks, if 2.5mg was well tolerated. For Zoloft, you could try 12.5mg initially, then potentially 25mg if tolerated. I don't know what your doctor would think of this strategy. It is at least a very simple thing for you to try.
>Buprenorphine/samidorphan
I have heard of it yes. In fact, I was discussing it with Hello123 above.
>Risperidone was lowest dose possible then cut in half and it caused severe rage/anger
Are risperidone and mirtazapine the only drugs to cause this anger in you?
Posted by Bill82 on February 1, 2015, at 15:39:09
In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 1, 2015, at 15:33:51
Would be tempted to try the ssri again, but even at 15mg of vortioxetine for a whole I achieved very little reduction in ocd. But I will have to ask what they think. And so far yes, it was pretty scary too. Risperidal also caused bad salivation which was unpleasant
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