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Dr. Michael
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience:  Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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I have been prescribed anafranil but fear the side effects.

Resolved Question:

I have been prescribed anafranil but fear the side effects. Have had laser surgery to reduce eye pressure. Is this fear rational? Anxiety and OCD are pretty severe. How should handle side effects. Should I stop the med immediately and seek help or get an appointment ahead of time just in case?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Michael replied 2 years ago.
Hello. I believe I can be of help to you with this issue.

Your doctor is going back to an older 'family' of medication since the newer SSRI meds aren't working. Side effects are a problem with anafranil but really, not much to be concerned about---you'd let you doctor know what was going on and chances are he'd have you immediately cut back on the dose if you experienced anything really disturbing and the symptoms associated with the side effects would then go away within a few hours. Nothing dangerous assuming a low dose of the medication. You are over 60 so you will be somewhat more senitive to medication effects, side effects etc. But anafranil is really quite a good medicaiton for OCD and anxiety. Now, another thing that can help is the combination of medication and one of the more recently developed forms of therapy for OCD/anxiety such as cognitive behavioral therapy and acceptance and commitment therapy. The latter is quite promising. Have you seen a psychologist who practices one of these forms of therapy yet?
Customer: replied 2 years ago.
no,just meds so far. I feel like I've done something terrible like force a car off the road and into a tree. It's irrational but I can't shake it. I am going to seek out a therapist. I should have an appointment this week. My dosage is going to be 100mg a day. Is that too much to start?
Expert:  Dr. Michael replied 2 years ago.
Of course I'm not your physician and what I tell you is not an action you should follow---I am only sharing academic information that should be discussed with your doctor.

Many physicians would consider 100mg to be far too much to start a trial of this medication; 25 mg is more likely the usual start up dose for older adults; take at mealtimes to reduce some of the side effects; will take about 2-3 weeks for blood plasma levels to become optimal and stable. I'd be surprised if you ever needed to move above 50 mgs over time. 100mg is probably a very high dose for you---it is prescribed at these levels, but not for individuals over 60.

Your description of your fear of forcing a car off the road and being seriously worried and beset by this idea is a good sign that you do probably have moderately severe OCD. Psychotherapy (cognitive behavioral, and ACT therapy) is the way to go for you as well, I believe.

Let me know if I can be of further help. Please click on the green Accept button at the bottom of the screen.
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience: Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
Dr. Michael and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
thanks very much
Expert:  Dr. Michael replied 2 years ago.
My best to you!!
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience: Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
Dr. Michael and other Mental Health Specialists are ready to help you

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