Have Mental Health Questions? Ask a Psychiatrist Online
Greetings !Welcome to the site.I am Dr. Kaushik and i am a psychiatrist and i believe i can help you with OCD with my many years of experience in dealing with this condition.While CBT ( ERP Therapy -- Exposure Response Prevention therapy ) is considered to be very effective for OCD, but you see OCD as well as Panic attacks ( both of which are included in anxiety disorders ) is associated with neurochemical imbalance in the brain ( low levels of serotonin ) therefore use of an anti depressant drug which balances out the serotonin levels in the brain is important to overcome OCD and panic attacks.So i will humbly suggest you to ask your family doctor to start you on an anti depressant drug such as Lexapro ( generic name -- escitalopram ) at dose of 10-20 mg / day or Zoloft ( generic name -- sertraline ) at dose of 50-150 mg / day , any one of the these two drugs shall be used to counter the obsessional thoughts about having a panic attack ( i.e clinically termed as Anticipatory anxiety) plus the underlying panic attacks.In addition to lexapro or zoloft you shall also ask your doctor to add klonopin ( clonazepam ) at dose of 0.5 mg mainly used PRN that is as and when required at times of overwhelming anxiety / obsessional thoughts.The drug therapy comprising of lexapro / zoloft + clonazepam ( PRN use ) taken for 4-6 months in combination with CBT shall see through the obsessional thoughts for panic attacks as well cause remission of panic attacks.So basically speaking CBT alone is not adequate to help you to deal with your problem therefore you should discuss the above mentioned regime with your doctor and get started on the same and you may expect improvement to start within 2-3 weeks but for complete recovery the drug regime needs to be taken for the above mentioned period.I hope this helps.Wish you all the best.Please kindly leave a Positive rating if you are satisfied with the answer.If there is any further assistance needed please feel free to ask using the reply button.Regards.
Thank you Dr. Kaushik.I have been suggested that Zoloft would be helpful. I have been resisting due to my fear of side effects along with the fact that I take a .5 mg of ativan most days of the week and I was fearing any withdrawal with that.Do you think this thought is stuck because of chemicals or it's something I can break down with therapy. Obviously there is an underlying fear here. Thanks for all your help.