[ 會員#25776 ] Sam
A question about refractory OCD, GAD and MDD
I have MDD, GAD, OCD and ASD. I have tried Zoloft, Lexapro, Prozac, Paxil, clomipramine, Remeron, Cymbalta, Pristiq, Seroquel, Abilify, Zyprexa, Risperdal, lithium, Depakine, Klonopin, Ativan, Xanax, Lexotan, Inderal and Lyrica. Please see my current prescription below:
1. Fluoxetine 80mg daily
2. Mirtazapine 45mg at bedtime
3. Aripiprazole 30mg daily
4. Olanzapine 15mg nocte
5. Clonazepam 0.5mg tds prn
6. Lorazepam 0.5mg tds prn
7. Pregabalin 250mg om and 250mg nocte
8. Valproate sodium CR 200mg nocte
9. Promethazine 100mg nocte prn
10. Lithium carbonate CR 400mg nocte
After trying so many medications, my OCD, anxiety and depression still make me dysfunctional. I can't resume my university studies or leave my home alone. I see my psychiatrist, clinical psychologist, counselor and social worker regularly. My psychiatrist said she would not recommend ECT. I tried rTMS and dTMS but they don't work. Esketamine and MAOIs are not available. What can be done to bring my OCD, anxiety and depression under control?
1. Fluoxetine 80mg daily
2. Mirtazapine 45mg at bedtime
3. Aripiprazole 30mg daily
4. Olanzapine 15mg nocte
5. Clonazepam 0.5mg tds prn
6. Lorazepam 0.5mg tds prn
7. Pregabalin 250mg om and 250mg nocte
8. Valproate sodium CR 200mg nocte
9. Promethazine 100mg nocte prn
10. Lithium carbonate CR 400mg nocte
After trying so many medications, my OCD, anxiety and depression still make me dysfunctional. I can't resume my university studies or leave my home alone. I see my psychiatrist, clinical psychologist, counselor and social worker regularly. My psychiatrist said she would not recommend ECT. I tried rTMS and dTMS but they don't work. Esketamine and MAOIs are not available. What can be done to bring my OCD, anxiety and depression under control?
林樹強醫生回覆:
5/5/2022
5/5/2022
Maybe you should learn to live with the illness. You can talk to the doctor to consider simplifying your long list of medications to minimize side effects if any (e.g. tailing off those added no benefit one by one). Stay on minimal necessary medication first and then try further refining the regimen carefully. Meanwhile you should learn to cope with the symptoms and strive to maximize your functioning e.g. traveling alone. Then set reasonable targets one by one. Rather than putting all your hope on finding a magic drug or any new treatment which can quickly fix all the problems.
Dr Liem
Dr Liem
以上資料只供參考，不能作診症用途，
請與家庭醫生查詢並作出適合治療。
如有身體不適請即求診，切勿延誤治療。
若資料有所漏誤，本網及相關資料提供者恕不負責。
請與家庭醫生查詢並作出適合治療。
如有身體不適請即求診，切勿延誤治療。
若資料有所漏誤，本網及相關資料提供者恕不負責。
Sam : mirtazapine vs fluoxetine
醫生你好，我有OCD，焦慮症，抑鬱症，現正服用250mg clomipramine。我同時服用45mg mir.......benwong : pinazepam 副作用
病患者男 - 32歲 想問下如果有驚恐症食緊藥，但夜晚瞓覺會醒一兩次但瞓得返著，係咪唔需要食呢隻藥？.......Anson Cheung : 思覺失調
病患者女 - 57歲 我媽媽患有思覺失調，現在每晚服用Sertraline HCL 50 mg 兩粒，O.......Giselle : 驚恐唔斷尾
病患者女 - 24歲 幾年前唔開心一段時間，出現panic attack,當時醫生當驚恐症咁醫，食咗好幾....... 發出提問使用細則
致林樹強醫生 提問
