Progress

[Brendan]

I decided to post here rather than in the General forum, as I did in my first thread http://forum.psychlinks.ca/general-support-and-advice/23723-strange-recent-ideations.html, since I was told these are obsessive thoughts.

For a while the anxiety from these thoughts diminished. But, more and more terrible thoughts and ideas keep coming to me. Like, today, it feels like some demonic influence keeps wanting me to break up with my boyfriend, despite the fact I would never, ever do that. We love each other so much. I would likely become suicidal if we ever broke up. Any happy image or story is accompanied by these terrible and dark thoughts, which has the dual effect of sapping happiness from my life and makes me anxious. I think perhaps it's worst on some nights, when I try to sleep, and there is absolutely nothing to distract me from it besides drowsiness, which sometimes isn't present.

I know I should go to a doctor (which will be next month) for medication or some diagnosis, but, I guess I'm trying to ask, will I ever be fully at peace with these new, disgusting ideas, or will I always have anxiety and need to be medicated for the rest of my life? I don't like this. Some days I question my sanity or ability to conduct myself in a moralistic, ethical manner.

 

[Daniel E.]

In a nutshell, things will get better but a person with OCD will probably always have OCD tendencies. As far as medication, I don't think most people with OCD will need medication their entire lives, and the author of Brain Lock would seem to agree.

More info:
http://forum.psychlinks.ca/obsessive-compulsive-disorder-ocd/23831-treatable-or-curable.html
http://forum.psychlinks.ca/obsessiv...lest-obsession-obsessing-about-obsessing.html

 

[Brendan]

I'll read the links tomorrow. But, I thought anti-depressants were used for people with OCD or intrusive thoughts, both to limit the thoughts and to treat the recurring anxiety. I'm pretty reluctant to get in one of them because of the sexual side effects, but, I may not have a choice if this persists or gets worse. It's very disconcerting, and I don't know why suddenly, at age 30, this is happening to me.

 

[Daniel E.]

With any given SSRI, most people don't get a single side effect. Also, some drugs like Lexapro may be less likely to cause sexual side effects compared to some of the older SSRIs (like Paxil):

Improvements in SSRI/SNRI-Induced Sexual Dysfunction by Switching to Escitalopram - Journal of Sex & Marital Therapy (it's a retrospective study, which isn't as good as some other studies)

So, in any case, one can always switch. And what is sometimes done is taking Wellbutrin along with a SSRI, such as if the SSRI was causing sexual side effects.

Of course, for the most effectiveness, you really want a multimodal approach that includes medications as well as the behavior therapy mentioned in Brain Lock.

 

[David Baxter PhD]

The SSRIs with the best anti-obsessional properties are (1) Luvox (fluvoxamine) and (2) Prozac (fluoxetine), in that order. They are also less likely than most to result in sexual side-effects (especially Luvox). You might mention your concerns to your doctor and ask about those specific medications.

As for the thoughts about your boyfriend, again they sound more like worries or fears than intentions.

 

[Daniel E.]

So to reiterate some of the points above regarding sexual side effects of SSRIs:

Luvox (fluvoxamine) seems to be pretty good in that respect, too.

However, there's really not much to go on to predict individual response to any of the SSRI or SNRI medications - you may need a little trial and error. Even if a parent or sibling experiences a certain side-effect from a medication, it doesn't mean that you will. The reality is that most people don't experience side-effects and those who do can usually resolve the issue by switching to a different SSRI. Since the specific side-effect you experience will give your doctor more in formation as to how your body/brain responds, most people can get the benefits without the side-effects by the second or third SSRI they try.

As an example, Effexor is one of the medications know for two side-effects: changes in sleep and changes in sexual function. But of those who have problems with changes in sleep or fatigue, about as many people experience excessive sleepiness as experience insomnia (and again about 80% don't have either side-effect). Similarly, while Effexor is more likely than some other SSRIs to produce some sort of sexual side-effect, most don't have this problem and for those who do predicting exactly how it will affect sexual functioning is almost impossible: while some people experience reduced libido, delayed orgasm, or anorgasmia on Effexor, other experience heightened libido and improved orgasm (one female client who was previouslay anorgasmic for a number of years became multiorgasmic on Effexot).

The best advice, I think, that anyone can give you is to work with your doctor and be prepared for a little trial and error.

Also note that if you do experience an unwanted sexual side-effect, some people find that combining Wellbutrin (which isn't usually the best antidepressant on its own) with an SSRI may help to counteract the unwanted side-effects of the SSRI.

http://forum.psychlinks.ca/prescrip...ressants-and-mood-stabilizers.html#post149061