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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4034
Experience:  MD Psychiatry
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Do you have any experience with OCD, more specifically "Pure

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Do you have any experience with OCD, more specifically "Pure O" and the thoughts of/fear that someone will hurt others? I was diagnosed with this about 5 years ago although other intrusive were there when I was about 12. I have always had some depression. I went off my antidepressants about 6 months ago and the harm thoughts came back full force along with worry that I was becoming psychotic, schizophrenic or had BPD. I took myself to the hospital and the psychiatrist diagnosed me with MDD with psychotic features (I was having some paranoia that my coworkers/roommate thought I was crazy because I was obviously in distress). This really really scared me. I was discharged 5 days later only on Zoloft. I moved home and started seeing a psychologist (seeing him for about 3 months now). He has not changed my medication and says it is just OCD – he thinks that the psychotic features diagnosis may have been incorrect. Anyway, I am writing because I am really worried that I will go psychotic since I was given that diagnosis and possibly hurt someone because maybe I will turn into an uncaring psycho that is ruled by their own thoughts, or maybe that deep down I am a really bad person or I have this potential to become psychotic. Any advice would be appreciated!!
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 1 year ago.

Hi there,

 

Welcome to Just answer !

 

I am sorry to learn about your condition and I empathize with you.

 

Kindly please tell me what all drugs other than Zoloft are you taking right now ? Also please mention the dose of Zoloft that you are currently taking and also the doses of other drugs if at all they are being used ?

 

Regards..

Customer: replied 1 year ago.

I am currently taking 200 mg of Zoloft per day. And I am prescribed Trazadone to sleep - 100 mg per day at night as needed - although I sometimes only take 50 mg (the psychiatrist said this is okay). I also have klonopin 0.5 mg once daily as needed. I haven't been taking that at all but last night I took 1 mg because I was anxious and it helped me fall asleep. Feeling very anxious now.

Customer: replied 1 year ago.

Sorry i didnt mention the other meds previously. I think that maybe because they are just as needed that i didnt think of them as being that important, but they are.

Expert:  Dr. Kaushik replied 1 year ago.

After having a look at your drug regime i will like to suggest some basic changes which go well with effective management of OCD symptoms.

 

-- It will be a good ploy to introduce an antipsychotic drug such as either abilify ( aripiprazole ) at dose of 10-15 mg / day or zyprexa ( olanzapine) at dose of 10-20 mg / day to your current drug , the reasons being :-

 

1) Your obsessional thinking and compulsive rituals ( if at all present ) will be effectively curtailed by the antipsychotic chosen form the above options.

 

2) Your diagnosis is still inconclusive owing to 2 different diagnoses coming from two different professionals but one cannot rule out the fact that you had paranoid / delusional beliefs in the past which keep the diagnosis of psychosis in contention , so the use of anti psychotic will prevent development of psychosis if at all it tries to develop in the first place but the addition of this drug will provide you a more rounded and complete drug regime to manage your symptoms.

 

3) Both anti psychotics mentioned above have an additional sedative action , so whichever out of them when chosen shall be used at night time so that it can bypass the need for use of trazodone to induce sleep since the antipsychotic drug will do the job for you in addition to it's main actions. And if at all trazodone has to be used in addition then it's dose shall be reduced to minimum possible dose of 25 mg / day which will only help your compliance.

 

So to summarize the below mentioned drug regime shall suit you most--

 

-- Continue use of Zoloft and klonopin in their respective doses as they are being used right now.

 

-- Add 1 of the above mentioned anti psychotic drugs for managing ocd and prevention of psychosis and helping in sleep problem.

 

-- Trazodone to be withdrawn completely or reduced to minimum dose after introduction of anti psychotic drug.

 

Kindly discuss this with your doctor.

 

I hope this helps.

 

Wish you all the best.

 

Please kindly leave a Positive rating if you are satisfied with the answer as only then will i be credited for my service.

 

If there is any further assistance needed please feel free to ask using the reply button.

 

Regards..

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4034
Experience: MD Psychiatry
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