Posted by greywolf on September 11, 2012, at 23:18:37
In reply to Re: Bipolar/OCD long-term med issues, posted by jono_in_adelaide on September 11, 2012, at 22:13:39
> Have you tried a high dose SSRI (say Zoloft 200mg) along with an NARI (say nortriptyline - dose determined by blood levels) along with an atypical antipsychotic (say risperidone or olanzapine or quietipine sr at night)
>
> Both atypicals and NARI's have been shown to boost the action of the SSRI's in OCD, attacking the OCD with three drugs with different modes of action might get you over the line, or atleast somewhat closer to it.
>
> I believe that in certain extreme cases, psychosurgery still has a small role to play - and you seem to be at the end of the line, so it might be worth looking into.
>
> Also it might be worth considering treatment at a highly specialised institution, for example the Menninger ClinicThanks for your thoughts. I have been the way of SSRIs combined with SNRIs/anti-psychs many times. I've been fortunate to also have several pyschiatrists review my lengthy med history, but they have nothing to add in terms of new strategies. None of the combos have had any significant beneficial effect on the OCD. The only combo that has had even a small effect has been Anafranil and Tegretol, but it was inconsequential in the face of my OCD symptoms.
Therapy twice a week has been the only thing allowing me to keep pace with the OCD. I was fortunate enough to treat for several years with a noted US specialist in CBT for OCD, and I spent a month at the University of Pennsylvania Center for the Study and Treatment of Anxiety, which is one of, if not the, best OCD treatment centers in the country. While the treatment was helpful with some of my low-order behaviors, the big ticket items were left untouched.
I'm trying hard to keep a positive mindset and to move forward with the current regimen, but I feel like all this effort the past few years has been going merely to treading water. It's kind of worn me out.
poster:greywolf
thread:1025444
URL: http://www.dr-bob.org/babble/20120830/msgs/1025471.html