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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
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Experience:  Dr. Mark is a PhD in psychology in private practice
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My daughter was placed on Lexapro about three years ago for

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My daughter was placed on Lexapro about three years ago for compulsive behavior, worrying about little things, checking her book bag two or three times for homework on the way to school. After the first few weeks being on Lexapro I saw a big personality change,no emotion, no social skills. This was a girl that loved to talk with people. She came off the drug and the symptoms returned. She's been back on it now for about a year, and the same non caring person has shown up again. My wife is a nurse, we have three girls, I've been in sales for 28 years, I'm more intune with her and I can't get it throught to my wife. Question? Are there instances where Lexapro has this effect on people and is there any other drug that we could try?

Hi! I believe I can be of help with this issue.


First let me say that I can imagine how difficult and frustrating this situation must be for you. You are clearly a loving and caring father and that's beautiful and so important for your daughter. My first concern is that you and your wife be on the same page here.

There's no need for the two of you to feel so far apart. Clearly the Lexapro gave relief of the OCD symptoms but you noticed undesirable side effects. Lexapro is an SSRI and that class, like others, can indeed cause a flattening of emotional affect in some people. But your wife may be concerned about the even worse problem your daughter faces when she has to contend with the OCD.

However, there are ways for both of you to see your concerns addressed. Luvox is an SSRI that has had very good results with OCD symptoms. That it's the same class of drugs does not mean it will cause the same side effects but it may have the same symptom relief. That would be the first drug replacement possibility to discuss with her doctor.

Zyprexa is used quite a bit but may have side effects. So discuss it with your doctor as to what his/her experience with it has been. A lot of the decision, when it comes to medication choices, can depend on a doctor's historical experience with those medications. Effexor is not quite as "strong" as Zyprexa but is a medication that has had good results for people.

The pharmacological treatments for OCD today are much better than in the past. But still, the most effective way to deal with OCD is with a combination of meds and Behavioral Therapy or Cognitive Behavioral Therapy specific to OCD.


I'd like to make sure it's clear that I view the medications as being vitally important tools in the treatment of OCD and anxiety disorders. But it is also important to remember: medications work on SYMPTOMS, not on what's going on with her as a human being. The problem with just focusing on symptoms is that we are human beings, not biological machines. So very often, when a medication treats one symptom, the underlying human condition that causes you depressed emotions pops up some other way and you are continually chasing after symptoms with your doctors. The research has shown (and my experience as a psychologist has certainly shown this) that psychotherapy WITH medications is much more effective than medication alone. Sometimes it can help the person reduce medications. With OCD Behavioral Therapy specific to that disorder is still the most effective treatment, especially with meds.



If your doctor isn't able to refer to anyone, here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (they show you a photo of the therapist!) look at the listing and see if they list CBT therapy in their orientations and OCD as one of the areas they work with. This is important: make sure they are experienced with OCD.


http://therapists.psychologytoday.com/rms/

You can also become knowledgeable on the disorder yourself or have your daughter become knowledgeable. I have found that patients who gain knowledge often gain a feeling of mastery over their problems. And that helps them in treatment. Here are some books to start with:

Stop Obsessing:? How to Overcome Your Obsessions and Compulsions by Foa and Wilson. Make sure to get the revised edition. Dr. Edna Foa is a renowned expert.

The OCD Workbook by Hyman and Pedrick. The exercises here are excellent.

Brain Lock: Free Yourself from Obsessive Compulsive Behavior by Schwartz. He's purely cognitive in approach and I've had some people really like his approach though some find it a little too vague. See what you think.

Tormenting Thoughts and Secret Rituals by Osborn. Dr. Osborn has OCD. The book is based on his group therapy and the techniques may appeal to you very much.

Okay, again, I want to stress that you and your wife don't need to be on opposite sides here. There are other meds that can give good results and perhaps reduce side effects. And there is the option of therapy as well.

I wish you and your daughter the very best!


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