[ 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。
lameiiibb : 驚恐症
病患者女 我有驚恐症，早期是看私家醫生，醫生說我病情不重，應該會好快好番，但因為費用不便宜，我轉到明心樓睇，.......Mike : 由細到大我都覺得自己怪怪地
病患者男 - 18歲 唉，唔好意思煩到咁多位。其實由細到大我都覺得自己怪怪地，鍾意諗好多野，覺得自己怪怪.......Gordon : 抑鬱症服藥初期
病患者女 - 65歲 你好,剛復發的中度至重度抑鬱症 再次吃藥 SERTRALINE 50mg 剛服.......Miss Lai : 鬱躁症病人可唔可以吃Wellbutrin
病患者女 - 55歲 我患了鬱躁症廿十年，病情反覆，時好時壞，已試過很多精神科藥，最近一年換了新政府医生.......Arale : 想死念頭
你好。 請問怎樣可以停止想死念頭？ 抑鬱症， 有穩定服藥。....... 發出提問使用細則
致林樹強醫生 提問
