David: Do the OCD symptoms become less or more intense with age?
Dr. Peck: I think OCD is more painful in the earlier years -adolescence and young adult. It may continue through old age, but the person may learn how to deal with it more effectively.
Starfish: Dr Peck, I get thoughts stuck in my head, I repeat thoughts over and over, about nothing in particular. Is that considered an obsession?
Dr. Peck: I believe it is.
Ziglen: What would you suggest to someone for whom the OCD medications do not work, and for whom CBT has been refused because their problems are "too long-standing, too deep rooted and too extensive" and told to come back for reassessment after 5 or 10 years of psychotherapy? I live in torment daily and cannot work or get on with my life.
Dr. Peck: Have all OCD medications been tried --even those for anxiety?
Ziglen: Yes, but my General Practitioner won't give me any tranquillizers now due to addiction problems.
Dr. Peck: I have patients who are addicts. They are self-medicating due to their painful and intrusive thoughts. I will give them tranquilizers because they need them, but I will insist they take them as prescribed and this usually works.
lorianne: I have been on Luvox for about 9 months, beginning at 50mg and progressing to 200 mg gradually. I have found it somewhat helpful, but I still "skin pick" quite a bit. I am selling my business, moving away and planning to re-marry. I am under great stress and anxiety around all of that. Is there another drug I might try that might be more suitable? My internist is very open to suggestions about this. And would it be instead of or in addition to the Luvox?
Dr. Peck: If Luvox works, I would keep on it. But another medication in addition would be helpful. I hear anxiety from you with all the changes, so an anti-anxiety medication might be my first choice here.
Carolyn: If OCD comes from a "deeper source" as you say it does...then how do you explain how the SSRI's and Anafranil work? Wouldn't OCD have to originate from a brain chemical imbalance then?
Dr. Peck: I believe that the trauma of some sort is the cause of psychiatric conditions including Obessive-Compulsive Disorder. Once it occurs (often in childhood), it causes a change in brain chemistry, thus the drugs are needed for this chemical change which remains until treated.
Starfish: Do you think that hormone changes after childbirth or menstruation affect OCD?
Dr. Peck: I believe if you are prone to OCD, after a body change such as menstruation, you have a better chance of getting it or any emotional problem you might have.
bbal7: I started getting obsessive thoughts at around 14yrs old. I don't do the rituals, but have the scary thoughts. It got really bad when I had my daughter but Zoloft has helped me, I believe. If I have another child, what are my chances of getting postpartum OCD and depression again? I still get the thought that I will "lose control and just kill myself". Especially when I am tired or stressed out.
Dr. Peck: You just don't know if it will reoccur with the next birth. If you are prepared, you are better off.
7sparrows: My son is ten and has OCD. He also shows all the classic symptoms of ADD (Attention Deficit Disorder). We tried treating him with Ritalin, and he really went crazy! Everything got much worse. We took him off the Ritalin and he calmed down. My question is, can Obsessive-Compulsive Disorder have similar symptoms to ADD and be misdiagnosed?
Dr. Peck: I believe it can. Have you tried Adderall? Or even a drug for anxiety. There is also a new drug--Zyprexia which I find works well for a number of problems.
lmoore: Have you ever heard of using Ultram for OCD? I have spoken personally with Dr. Nathan Shapira who is currently running a clinical trial for the use of Ultram for OCD. It seems some people are opiate sensitive and respond very well to this drug. I understand its main effects are serotonergic and norepinephrine. I am a resident in anesthesiology and have tried Ultram on my own with very successful results. What are your thoughts?
Dr. Peck: Interesting comment. A number of patients in great "pain" like the narcotics because it relieves intrusive thoughts. Obviously it creates other problems.
DamagedPsyche: How do you feel about behavioral therapy opposed to cognitive therapy for OCD?
Dr. Peck: I like the concept of cognitive therapy. It teaches a person about themselves. Behavior therapy exposes one to this problems. Many illnesses are intertwined. In Post Traumatic Stress Disorder (PTSD) behavior therapy is suggested but I feel it terrifies the patient more. There is a primitive brake-in in all of us and that is where mental illness occurs. We don't need to stress it any more.
LexuskelA: I don't remember always being like this- can OCD pop up in your life at any time?
Dr. Peck: It probably is always there, and when it pops up, it may be a defensive mechanism or you may suddenly may be bored and thus feel vulnerable.
madi: My OCD has reached points in my life where it was extreme, and then it backs off for a while. Is this normal?
Dr. Peck: It seems to be, and you have had it long enough to learn how to live with it more effectively.
David: I know it's getting late. I want to thank Dr. Peck for being our guest tonight. For more info you can visit Dr. Alan Peck website. I also want to thank everyone in the audience for coming and participating tonight. I hope you found it helpful.
Thank you again, Dr. Peck, for coming and answering so many questions.
Dr. Peck: My pleasure. I hope I was of help.
David: You were. Good night everyone.
Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.