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It is not uncommon for those suffering with obsessive compulsive disorder ( OCD) to develop other forms of mental illness. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are the most common diagnosis’s that are associate with OCD. The addition of these disorders can interfere with or complicate treatment if they are not addressed. The use of medications can be beneficial in reducing the anxiety and depression as well as help with the symptoms of OCD, however, the medications are not meant to, nor can they stop the obsessions. The medications will lessen the symptoms of MDD and GAD that often prevent the patient from continuing the full spectrum of therapy. So, what is the best medication for ocd with mdd and anxiety
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Prescribed Medications Used in Treatment Of OCD:
Two types of medications have been used as effective treatment for the treatment of OCD, tricyclic antidepressants (TCA) or selective serotonin reuptake inhibitors (SSRI). Research has shown that people suffering with OCD may have an imbalance or less serotonin, a neurotransmitter in the brain, than what is needed. Due to the decrease in serotonin, those diagnosed with OCD are prescribed SSRI’s which is the preferred medication as part of the treatment. The side effects of SSRI’s are shorter and milder than those produced with TCA’s.
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Serotonin Reuptake Inhibitors (SSRI’s):
- Fluoxetine, brand name Prozac. The use of Prozac for part of the treatment of OCD will typically take approximately four to twelve weeks for the decrease of symptoms to be significantly noticed. The prescription Prozac is becoming used less as part of the treatment due to the length of time it takes for the medication to get out of the system which makes it difficult to switch the medications when Prozac is causing relief.
- Fluvoxamine, brand name Luvox. Luvox was the first FDA approved, non TCA treatment of OCD. Luvox under the brand name has been withdrawn from the United States drug market, however, it is continues to be sold outside of the US and is available in the US in the generic form. The pharmacy that produces the medication Solvay Pharmaceuticals does not have intentions of reintroducing Luvox into US sales.
- Paroxetine, brand name Paxil. Paroxetine will stay in the system longer than the other drugs and is the most potent of the SSRI medications. The medication has a longer half life than other SSRI’s and requires the dose to not exceed 60 mg. per day. There is a transition period as well, meaning the dosage is typically began at 10mg per day and increased by 10mg per week.
- Citalopram, brand name Celexa. Clexa has good results for interactions with other medications but, it has not been used very long for the treatment of OCD. Celexa has been proven to be effective when used for OCD when depression is also present.
- Sertraline, brand name Zoloft. This is the most widely prescribed medication in treatments for OCD due to the favorable response in working well for treatment of OCD. Zoloft is considered to be the safest of the SSRI medications and it has an effectiveness at a low dose of 50mg and 200mg. The lower dose is recommended, however the dosage is safe up to 200mg per day. Zoloft also mixes well with other medications used in the treatment of OCD and the accompanying mental illnesses.
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Tricyclic Antidepressants (TCA)
Clomipramine, brand name Anafranil. This is the only TCA’s that are still used in the treatment of OCD. It is as effective as SSRI’s, however is typically only prescribed when the SSRI’s are not working. The starting dosage is 25mg to 50mg and will be increased as little as daily and up to every three days by 25 to 50mg each dose until a dosage of 250mg is achieved. The side effects include jittery feelings, lightheaded, nervousness, over stimulation, difficulty sleeping and sexual dysfunctions, all of which resemble the symptoms of anxiety, making it difficult for the individual to distinguish between side effects and anxiety. Clomipramine, brand name Anafranil. This is the only TCA’s that are still used in the treatment of OCD. It is as effective as SSRI’s, however is typically only prescribed when the SSRI’s are not working. The starting dosage is 25mg to 50mg and will be increased as little as daily and up to every three days by 25 to 50mg each dose until a dosage of 250mg is achieved. The side effects include jittery feelings, lightheaded, nervousness, over stimulation, difficulty sleeping and sexual dysfunctions, all of which resemble the symptoms of anxiety, making it difficult for the individual to distinguish between side effects and anxiety.
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The majority of the SSRI’s used in the treatment of the OCD symptoms are also effective in treating the major depressive disorder symptoms the individual may experience. However, someone suffering with MDD may be prescribed other medications such as Wellbutrin or Effexor, both of which can be taken with SSRI medications. Wellbutrin and Effexor are known as atypical . Atypical medications differ from the SSRI’s where they concentrate on serotonin, the atypical concentrates on the neurotransmitter dopamine. Both are effective and good results in the treatment of MDD when there are symptoms of OCD as well.
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The SSRI medications are also beneficial in treating the symptoms of anxiety. Also used in conjunction with the SSRI’s are the prescription medications BuSpar, trazodone, venlafaxine and a majority of benzodiazepines including Valium, Xanax, Librium and Serax. All of which will work well in the anxiety symptoms of OCD, however, the benzodiazepines are often used as a last option due to the ease of addition to the medication.
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Introduction -Common Medications for Anxiety Disorders http://www.anxieties.com/med-intro.php
Medication for Obsessive Compulsive Disorder, Many Effective Choices for OCD http://www.brainphysics.com/medications.php
National anxiety foundation, Interesting Facts About OCD. http://www.lexington-on-line.com/naf.ocd.2.html
Antidepressant Medications http://www.allaboutdepression.com/med_01.html