Anxiety and OCD Medications - OCD Medications

Written by HealthyPlace.com Staff Writer

hobster: If you were treating a patient who is housebound, with some form of OCD with an eating problem, would you recommend medication, cognitive behavioral therapy, or would you recommend Seroxat?

Dr. Watkins: I do not know what Seroxat is. I would recommend CBT and an SSRI. I might also start a Behzodiazepine. Housebound patients may need a couple of home visits from the doctor or a treatment outreach person until they can get into the clinic. For treatment resistant anxiety I may augment a SSRI with Lithium, Depakote, or I may use a beta blocker such as Propranolol. MAO Inhibitors such as Parnate and Nardil can be quite effective, but you need to be on a special diet and they can lead to weight gain. They are probably underused. I don't combine the MAOI with other medications in most cases.

David: Just to clarify hobster's question before, Seroxat is the UK name for Paxil.

Kerri20: I did cognitive behavioral therapy and exposure therapy for about three weeks and I found it was working great. I noticed I went down hill after stopping therapy. I guess I want to know what is the average length of time that someone would be in therapy to get the best out of it, or to keep it up, so to speak.

Dr. Watkins: You can have relapses after stopping either therapy or medication. The time frame varies. I usually recommend follow up therapy sessions as "boosters." When I stop the active phase of treatment, I have the patient and often a significant other write down the early warning symptoms. We make plans for what we will do if it starts to come back (anxiety disorder relapses). We write these down and everyone has a copy. Same process for coming off medications.

Cortny9: I am nine years old and I take Zoloft. It has helped me a lot. But my mom and I would like to know if there are long term side-effects?

Dr. Watkins: Paxil is a good SSRI to use for a patient with OCD. We don't have a lot of long term data on Paxil in children. However, physicians are supposed to send in reports of problems with medications. I haven't seen severe long-term side-effect reports.

Brin: Should a nine year old be on Zoloft?

Dr. Watkins: Zoloft can be used in children that age with OCD. Each case is individual. I look at a variety of treatment options in a child with OCD. There is a great book, "Blink, Blink, Clop Clop, Why Do We Do Things We Can't Stop?" that explains OCD to children.

David: You can visit the HealthyPlace.com psychiatric medications area, if you are looking for information on a particular medication.

tracy565: Do people with panic disorder need to be on medication all their lives?

Dr. Watkins: Not necessarily. Some people learn techniques to deal with the symptoms. I will taper it in some people and have them step up their therapy while we do the taper.

sgroove63: I've been on Serzone for anxiety and anorexia and bulimia for about a month (up to 200mg). I have had strange side effects. I'm dizzy, spacey, silly, and have a lack of coordination. How serious are these? My psychiatrist also started me on a small dose of Celexa a week ago, I think in anticipation that the Serzone won't work for me. What do you think?

Dr. Watkins: I have had several people who have had those types of symptoms on Serzone. Often, they are the same people who have trouble on Prozac. Celexa might be a good substitute for the Serzone. Ask your doctor if she is planning a substitution or if she intends to keep you on both. You need to use caution if you combine the two.

David: Why, what can happen?

Dr. Watkins: Sometimes, when you use two different medications that act on Serotonin, you can get a buildup of the Serotonin. This can occasionally lead to Serotonin Syndrome, one might get a bit disoriented.

Dr. Watkins: St. Johns Wort, combined with some medications can cause serotonin syndrome too.

Jitterbug: I have recently found that I have severe OCD and I don't like medication. However, I took the advice of my therapist and went on Zoloft. I then heard about Luvox and I was wondering which medication is better for OCD. I am having the hardest time functioning everyday. I'm feeling depressed and need something to help.

Dr. Watkins: Is your therapist also your psychiatrist? I am not keen on non-medical therapists recommending medication, unless the therapist is in very close contact with your psychiatrist. One is not necessarily better than the other. Luvox can interact with some other medications, so I tend to use it more by itself. I like it with children. Celexa may be less likely to interact if you are on a lot of different medications.

btlbaily: I have been on Zoloft for about six months. If I decide to get pregnant, is it recommended to discontinue the medication? And, if so, how long does it take to "wean" yourself off the medication?

Dr. Watkins: Some women do take Zoloft and Prozac during pregnancy, without problems. You need to discuss this with both your psychiatrist and your OB/GYN prior to conception. You should have your medications prescribed by a psychiatrist who is familiar with this sort of thing and who is willing to keep in touch with your OB. You need to go over the risks and benefits of taking the medication and the risks and benefits of going off medication.