Mental Health

Have Mental Health Questions? Ask a Psychiatrist Online

Ask an Expert,
Get an Answer ASAP!

Mental Health

For a PHYSICIAN please. I just took 100mg Dilantin. I have

Customer Question
ocd and hate taking zoloft...i...
For a PHYSICIAN please. I just took 100mg Dilantin. I have ocd and hate taking zoloft...i have decreased my zoloft to 25 to 50mg and at that level it does little for ocd...I borrowed 100mg dilantin from my brother and within an hour my ocd symptoms decreased dramatically...i think i will asky my dr. to put me on dilantin instead of zoloft. because dilantin is tried and true and peopel have been on it their whole lives and been SMART still. SSRI"s I do not trust I have been on them 10 years and have seen deterioration in my memory. I am only 27 and am trying to finish a degree but am too impacted by zoloft...i think DILANTIn may be my saviour. There is some literature that it helps in ocd...and i am much more comfortable taking that than zoloft. We just don't know enough about the long term effects of SSRI's on the brain . I am not saying dilantin may not have side effects but epileptics take 300mg ...100mg worked dramatically for me. what do you think?
Submitted: 8 years ago.Category: Mental Health
Show More
Show Less
Ask Your Own Mental Health Question
Answered in 44 minutes by:
6/3/2009
Mental Health Professional: Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner replied 8 years ago
Dr. Chris in Ohio
Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner
Category: Mental Health
Satisfied Customers: 20
Experience: 24 years Psych experience. Expert: psych meds, depression, bipolar, anxiety disorders, schizophrenia
Verified
DearCustomer

Excellent question....

I am a NP with the same DEA license and prescribing privilidges as a MD, and I have 24 years experience in psychiatry, so I think I am qualified to answer your question for you.

First of all, there is very limited information on Dilantin being useful to treat OCD. Remember that Dilantin works to "slow down" the central nervous system, thus its effectiveness in treating seizure disorders. Also, remember that according to virtually all research, Serotonin (which is enhanced by Zoloft type drugs; SSRIs) is involved with biological processes such as mood, aggression, sleep, appetite, pain, and OCD behaviors.

It also seems that Serotonin is capable of connecting to nerve cells in the brain in many different ways and so can cause many different responses. A malfunction in one or more of the receptors in the brain that Seretonon attaches to is thought to cause OCD.

I work with a psychiatrist who has a subspecialty in treating OCD. Here are some things that we use to treatment resistant OCD. By the way, I have never seen any OCD patient on a SSRI loose their memory. Sometimes people on SSRIs have sluggish thought processes, which you may interpret as memory loss, but this is not permanent.

Our first choice of treating OCD is high doses of the SSRI Prozac. 60-80 mg. We NEVER use Zoloft, as it is not a drug of choice for OCD. Our second drug of choice is Luvox, with a higher dose of 200-300 mg per day.

Sometimes we will combine medium dosages of the above (40mg Prozac & 150 mg of Luvox) when one doesn't work alone.

Dilantin may work for you, but I honestly suspect that the positive effect you got is more of a "placebo" type effect. I would stick with the SSRI approach, and do not be afraid of the high dosages. These drugs are very safe, and although they may have some side effects, you will not lose your memory from any of them. Zoloft is a drug that should be best left in the arena of treatments for depression, not OCD.

Good luck.

Dr. CJH
Dr. Chris in Ohio
Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner
Category: Mental Health
Satisfied Customers: 20
Experience: 24 years Psych experience. Expert: psych meds, depression, bipolar, anxiety disorders, schizophrenia
Verified
Dr. Chris in Ohio and 87 other Mental Health Specialists are ready to help you
Ask your own question now
Customer reply replied 8 years ago
Thanks for your response but I am still very afraid of SSRI's despite many dr's saying they are safe even long term (I have been on 10 years). At the same time if dilantin at a low dose worked...i know you suspect placebo effect but IF it did work for me I would choose that over ANY SSRI because it has been around 70 years and people have been on it an entire lifetime from childhood and been succesful academically. We cannot say the same for SSRI's as their use is only 20 or so years old. I have what some refer to as Pure Obessional OCD and my thoughts are about getting brain damage from various things one of them medications. I am seeing Dr. ***** *****on in NYC . Have you heard of him he is a OCD guru. I am working with him employing Exposure prevention therapy . Not many people treat pure obsessional ocd where there are no outward compulsions he is one of hte leading experts and supposedly most people can get of medication with therapy alone as OCD is a thought/anxiety disorder that can be treated with CBT alone in something like 80% of people. So I am very hoepful that I can get off meds. How long does the therapy take to work though that is the thing? Dr. Phillipson says that the intrusive thoughts can be weakened over time through habituation and I can one day live without drugs most likely.
Mental Health Professional: Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner replied 8 years ago

DearCustomer

If the Dilantin works for you, and we know it works directly in the brain by slowing brain activity, then I would say go forth, but please do so only under the supervision of Dr. Phillipson. Dilantin has one very nasty side effect.... over time your gums may overgrow, and begin to cover your teeth. To prevent this, brush your teeth VERY rigorously at least twice a day.

Good luck!

Dr CJH

Ask Your Own Mental Health Question
Customer reply replied 8 years ago
well what is "safer" on the brain in terms of cognitive problems surfacing ? ssri's or dilantin or one of the other seizure meds like carbemazapine?
Mental Health Professional: Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner replied 8 years ago

Depakote, an anti-manic, anti-seizure medication which is much like Tegretol. There has been research that shows early promise that it may in fact even reverse some of the anatomical changes seen in early Alzheimer's Disease.

Depakote (also known as Valproic Acid) is a very safe medication, is very inexpensive, and has a very solid track record.

Good luck!

Dr. CJH

Ask Your Own Mental Health Question
Customer reply replied 8 years ago
What about omega 3. I just started that in high doses it may increase serotonin enough for me to live a normal life without ssri's. that is what some literature says.
Customer reply replied 8 years ago
I also wanted to say my brother takes 300mg dilantin daily for 4 years. He had his first seizure at 18 and ended up intubated for a day because they were so severe and continous. He since then has been on 300mg dilantin and has a genius level iq. He has completed a computer engineering degree like it was nothing. I am however worried for his future...what is going to happen to his really smart brain from taking dilantin for many years...so far nothing has happened but what about in another 4 years?
Mental Health Professional: Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner replied 8 years ago

Glad to answer all your questions u2, but would appreciate whatever extra compensation you can offer....

Absolutely take Omega 3. I take 2 each day (a.m and p.m.). Not only will it help your memory, it reduces your cholesterol, helps keep you arteries clean, and serves as a natural anti-depressant.

The key is to buy "pharmaceutical grade" Omega 3, not the junk you can get at WalMart. I use Twin Labs brand. Most health food stores have it, and you can also buy it on line. Be sure to take them everyday.

Good luck!

Dr CJH

Ask Your Own Mental Health Question
Customer reply replied 8 years ago
what about its efficacy for ocd (omega 3) it has shown to be effective for many and that is without taking ssri's too.
Mental Health Professional: Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner replied 8 years ago

u2..... Omega 3 makes the brain function better, but as far as it helping OCD, I have never seen any literature on it doing that, although it definitely would not hurt.

OCD is best treated by increasing Serotonin levels as high as possible. As indicated earlier, Prozac in large amounts, or Prozac and Luvox.

Earlier this year we had a young woman who could not stop washing her hands. She had been on everything by other Docs. We put her on Prozac 40 mg. and Luvox 100 mg, and her OCD symptoms diminished by 70%. She essentially got her life back.

Stick with what has been proven. Adding Omega 3 could only help.

Good luck!

Dr. CJH

Dr. Chris in Ohio
Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner
Category: Mental Health
Satisfied Customers: 20
Experience: 24 years Psych experience. Expert: psych meds, depression, bipolar, anxiety disorders, schizophrenia
Verified
Dr. Chris in Ohio and 87 other Mental Health Specialists are ready to help you
Ask your own question now
Customer reply replied 8 years ago
but you have to look at the long term effects of taking ssri's and the jury is still out. it is not worth the risk to me...even though it is hell without ssri's. CBT can reduce my sypmtoms 70% too.
Do you think i want to be a brain damaged fool from taking ssri's for 30 years. ? I am working on finishing a degree in school and need my brain for years to come
Mental Health Professional: Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner replied 8 years ago
u2.. nope, there is absolutely no evidence that longterm use of any antidepressants, whether they are SSRIs, or the older tricylics cause any long term harm to the brain. Remember, they do not anatomically change the brain.... all they do is block the re-update of neurotransmitters as to increase their levels.

The new antidepressants are very non-toxic. People have tried to OD on Prozac, and are fine several hours later. Some of the older antidepressants have now been around for over 50 years. There is absolutely no corelation between having taken them longterm, and then developing Alzheimers, or having a stroke, or any other form of damage to the brain.

The jury is not out u2. In a few years, there will probably be a new generation of even safer drugs out there. If the SSRIs help you, do yourself a favor, and take them, and "don't borrow trouble" by worrying about what may or may not happen years from now.

Good luck!

Dr. CJH
Ask Your Own Mental Health Question
Customer reply replied 8 years ago
I know what you are saying but the INTERNET is inundated with forums where people claim that ssri's have damaged everything from their memory to their cognition and everything inbetween. How can we discount that?
Customer reply replied 8 years ago
also what about my dilantin question..it's toxicity long term
Mental Health Professional: Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner replied 8 years ago
u2, the worst long term side effect from Dilantin/Phenytoin is the gum problem I told you about earlier. Many people have been on it for decades, and are doing just fine.
There are tons of other anti-seizure meds now on the market, some of which we also use as mood stabilizers. Neurontin is another good one.
The one I recommend, without a doubt is Depakote (Valproic Acid). Click this link to read for yourself about some new, exciting research: http://www.webmd.com/alzheimers/news/20081027/valproic-acid-may-treat-alzheimers
u2..... chill my good man. Don't borrow trouble. Take what is available. Trust me, something better will be on the market sooner than later.
Dr. CJH
Ask Your Own Mental Health Question
Ask Dr. Chris in Ohio Your Own Question
Dr. Chris in Ohio
Dr. Chris in Ohio
Dr. Chris in Ohio, Ohio Psychiatric Nurse Practitioner
Category: Mental Health
Satisfied Customers: 20
20 Satisfied Customers
Experience: 24 years Psych experience. Expert: psych meds, depression, bipolar, anxiety disorders, schizophrenia

Dr. Chris in Ohio is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!!

Janet VPhoenix, AZ

< Previous | Next >

Meet the Experts:

Dr. Keane

Dr. Keane

Therapist

1,379 satisfied customers

Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.

TherapistMarryAnn

TherapistMarryAnn

Therapist

3,984 satisfied customers

Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.

Dr. Olsen

Dr. Olsen

Psychologist

2,336 satisfied customers

PsyD Psychologist

Norman M.

Norman M.

Principal psychotherapist in private practice. Newspaper contributor, over 2000 satisfied clients on JA

2,246 satisfied customers

ADHP(NC), DEHP(NC), ECP, UKCP Registered.

Dr. Michael

Dr. Michael

Psychologist

2,177 satisfied customers

Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.

Steven Olsen

Steven Olsen

Therapist

1,728 satisfied customers

More than twenty years of expertise in counseling, psychological diagnosis and education

Anna

Anna

Mental Health Professional

1,656 satisfied customers

Licensed Clinical Social Worker with 29 years in addictions and mental health.

< Previous | Next >

Related Mental Health Questions
What would you recommend to someone with a bad anxiety
Hi, what would you recommend to someone with a bad anxiety disorder, 25 years old, 134 lbs, who keeps worrying about fainting if he doens't... eat yet another meal? Driving and walking has become hard… read more
Nancy
Nancy
Psychotherapist
MS, PhD can.
492 satisfied customers
I have generalized anxiety disorder with panic attacks at
I have generalized anxiety disorder with panic attacks at times. For the most part I have improved a great deal through BCT and other lifestyle changes. I had it terrible after I quit smoking for abou… read more
Linda D.
Linda D.
Master\u0027s Degree
721 satisfied customers
OKMH1212211 I have an extreme medically diagnosed anxiety
OKMH1212211 Hello. I have an extreme medically diagnosed anxiety disorder. Recently, it's been getting worse. Everything makes me anxious and I have panic attacks regularly. I am allergic to all SSRIs… read more
Dr. Ravoof
Dr. Ravoof
Doctoral Degree
1,880 satisfied customers
I would like to know if it is possible for anxiety to cause
Hello,I would like to know if it is possible for anxiety to cause bladderproblems like urinary retention and bladder overactivity. Like if you fear it and you are constantly conscious regarding it, it… read more
TherapistMarryAnn
TherapistMarryAnn
Therapist
Master's Degree
3,984 satisfied customers
I have a history of health anxiety and panic. I went to hear
Hi. I have a history of health anxiety and panic. I went to hear a band Saturday and smoked about 5 cigarettes. I never smoke! I am very health conscious with diet, running, etc. I did smoke a few in … read more
TherapistMarryAnn
TherapistMarryAnn
Therapist
Master's Degree
3,984 satisfied customers
OKMH115211 My daughter struggles with anxiety depression
OKMH115211 My daughter struggles with anxiety depression OCD. She has tried numerous medications without any luck. She is at a new inpatient facility and her psychiatrist put her on zyprexa and Prozac… read more
Dr. Kaushik
Dr. Kaushik
PSYCHIATRIST ( MD Psychiatry)
Doctoral Degree
203 satisfied customers
Bipolar2,anxiety, avoidant pd.having swirling pinballing
bipolar2,anxiety, avoidant pd.having swirling pinballing dark thoughts. depressed, frustrated, feeling hopeless. I have taken many different meds in the past but what i am taking now doesn't work that… read more
Dr. Kaushik
Dr. Kaushik
PSYCHIATRIST ( MD Psychiatry)
Doctoral Degree
203 satisfied customers
I struggle with severe anxiety and depression and self love
i struggle with severe anxiety and depression and self love and self esteem and self confidene issues. i need help … read more
Therapist Leslie
Therapist Leslie
Masters, Professional Psychology
5 satisfied customers
I am wondering if I have anxiety. I can't stop thinking that
I am wondering if I have anxiety. I can't stop thinking that I have serious health issues due to some symptoms I am experiencing but have had tests done to rule everything out.… read more
Dr. Ravoof
Dr. Ravoof
Doctoral Degree
1,880 satisfied customers
I've had anxiety due to trauma... I've had anxiety due to
Hello, I've had anxiety due to trauma... Hello, I've had anxiety due to trauma in the city I lived in, I moved out to a different city, I accidentally spoke to somebody associated with the trauma , in… read more
Vakul Aren
Vakul Aren
Consultant Physician
Post graduation (Liverpool, U.K.)
3,904 satisfied customers
I am desperate for something to help with my anxiety. For
I am desperate for something to help with my anxiety. For instance, I'm sitting here inn a Dr's office ave a lady behind me id's chewing gum and I am so course to turning around and saying something b… read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
717 satisfied customers
I've been experiencing a lot of depression and anxiety after
second opinion] Hello!I've been experiencing a lot of depression and anxiety after a health diagnosis. I am constantly paranoid that something else more serious may be wrong with me. Constantly readin… read more
Therapist Leslie
Therapist Leslie
Masters, Professional Psychology
5 satisfied customers
I've been experiencing a lot of depression and anxiety after
Hello!I've been experiencing a lot of depression and anxiety after a health diagnosis. I am constantly paranoid that something else more serious may be wrong with me. Constantly reading forums and med… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,619 satisfied customers
I experience a lot of Generalized chronic term anxiety and
I experience a lot of Generalized chronic long term anxiety and it pains my heart and chest and surrounding areas a lot and legs and arms numbness and tingling which drains me out daytime drowzyness all day and coffee and teas don't help anymore … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
717 satisfied customers
OKMH925100 Is it possible to treat panic disorder/anxiety
OKMH925100 Hi! Is it possible to treat panic disorder/anxiety disorder without medication?? I'm in my mid-thirties and just started having panic attacks after a very stressful past 4 years (I thought … read more
LeahMSWuofm
LeahMSWuofm
Clinical Social Worker
Master\u0027s Degree
717 satisfied customers
I I have extreme anxiety especially social anxiety I over
I I have extreme anxiety especially social anxiety I over worry about everything and I have PTSD from being stabbed and assaulted I've been prescribed Xanax for years and I got up to 2 mg which was wo… read more
Vakul Aren
Vakul Aren
Consultant Physician
Post graduation (Liverpool, U.K.)
3,904 satisfied customers
I HAVE ANXIETY DRIVING MY TRACTOR TRAILER.HAVE TRIED ANXIETY
I HAVE ANXIETY DRIVING MY TRACTOR TRAILER.HAVE TRIED ANXIETY BUSPAR,LEXAPRO,CYMBALTAL.NONE HELP.BUT MADE SITUATION WORSE.BUT XANAX WORKS.NO SIDE EFFECTS AT ALL.HOW CAN I LEGALLY GET PRESCRIPTION FOR X… read more
Dr. Mark
Dr. Mark
Doctoral Degree
129 satisfied customers
Im struggling with anxiety, I started having anxiety about
I started having anxiety about 12 years ago after going through a divorce and then becoming self employed. However the frequency of my anxiety and strong attacks are happening more frequently. … read more
TherapistJen
TherapistJen
Licensed Clinical Social Worker
Master\u0027s Degree
950 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x