ADVICE NEEDED

I have asked my psychiatrist to try and increase my dose of sertraline from 200 mg, which is the max recommended dosage, to at least 225mg (studies have shown that in more severe Ocd cases, doses even up to 400 mg can really make the difference), but he refused. The reason he gave me was a possibility of developing the serotonin syndrome. Instead he prescribed an anti-psychotic, quetiapine in addition to the 200mg of Zoloft. He said it is what all psychiatrists prescribe in such cases. It has got nothing to do with the fact that I do not have any of the psychotic disorders, it just puts the cherry on the top of the sertraline cake. I am a vegan, try to eat as healthy as possible. On one hand, sertraline saves my life, it really is a blessing to me, but at the same time, on the other hand, it causes a long and hard range of physical problems. 10 years ago, and now again. After I reach the 100mg dose, I start gaining weight abnormally, my blood pressure rockets sky high, my LDL cholesterol is way too high, and I get diabetes 2. It all calms down only when I get to the 200mg of Zoloft. Interesting. Lower doses cause more problems than higher. In 2023 I gained about 27kg in 6 months. No diet, no exercise, no fasting, nothing works, I just can't lose weight on my own without medication. I ended up in hospital due to my super high blood pressure for 8 days in August 2023. Since then till now I have been to all possible specialists (cardiologist, neurologist, endocrinologist, diabetologist,....) to exclude all other possible culprits for all my problems. Every single one of them concluded that sertraline is the only one which is to blame, but since without Zoloft I have no life, and my life with it is like 90% better, it is better not to change it for another medicine and risk other complications. Instead, we should treat all the physical illnesses and conditions with the appropriate medications. It was a hell of a ride. So I went to the pharmacy and got the Kventiax (quetiapine). I read the patient directions for use. Among the very common side effects are: developing diabetes or worsening the existing condition, high cholesterol, high blood pressure, gaining a lot of weight, heart attack,... All the conditions I have been dealing with for a year and trying to get them under control with medications and guidance from specialists. I must say, I was very disappointed with my psychiatrist. He seemed to be ok, but now... he is well aware of all the health issues I have to fight because of sertraline and he prescribed a medicine that significantly worsens all of them. I refuse to take it. Instead, I contacted the very manufacturer of both Zoloft (Asentra) and Kventiax (quetiapine) and asked about the higher doses than max recommended of sertraline for ocd, about the serotonin syndrome and about my fears about quetiapine. Not only did they confirm that quetiapine very very commonly (in more than one patient out of ten) causes all the above mentioned problems, but that it is common knowledge among doctors and pharmaceutical professionals that even the lowest amounts of it can easily cause the serotonin syndrome. They stated that due to the law they can not recommend to go over the 200mg of Zoloft, but that studies show that higher doses are beneficial to some patients with ocd and that the side effects do not increase at all. There is no blood or other test to make sure that one hasn't developed the serotonin syndrome, but close cooperation of a patient and their psychiatrist can monitor it well. They basically said that if I was to change anything, it would be much smarter to increase the already existing medication (Zoloft), than introducing any other new one. I am now totally disappointed with my psychiatrist. My trust in him is on very weak legs. I am angry and sad and disappointed at the same time. He knew about all I've been through, he knows about all the medications I am taking and he bluntly refused to do what I know 100%sure would mean the world of a difference to my mental health and instead he prescribed an additional new medication, that could very possibly have killed me. I need to talk to him somehow. I am seeing him at the end of January. I have a possibility to call him, to ask for his email and send it all to him or to print it all out and send it to him via regular post. I don't know how to approach it. How do I tell him that he might have killed me. That I am an individual end not just one of all other people with ocd. How that I am terribly disappointed and feel like I can't trust his decisions with ease and confidence any longer. And that it made me feel hurt when he sort of cynically dismissed my suggestion by saying, yeah those Americans and their studies. What words do I use? I have a strong fear of conflicts. I usually come across people who when you express your opinion that is not like theirs or is in a way a show of their wrongdoings, that they become verbally aggressive, they attack and I usually become as small as a pea or my blood pressure raises and I try to get a word in edgewise so that I can stop them from walking all over me. It's always my fault and never theirs. I would greatly appreciate if you told me what you would do, how would you react and what would you say to him or write to him (my psychiatrist) if you were in my shoes. I don't want to argue with him or insult him, but I would like to tell him what he did wrong. This is serious. He could have killed me with his careless prescription of quetiapine. I am sorry for the length of the post (as usually). I just wanted to tell you the whole situation so that I could get some advice from you that could help me do what I need to do. Thank you in advance for being there when I need someone to lean on. All the best to all of you. 🙏

777Q

Date posted: 35w

HI NODA ! I am not an expert of any kind but personally I would not take over 200 mg of that medication.

NODA

Date posted: 35w

Thank you. I won't either. And I am not going to take the anti-psychotic either. If there is nothing I can do to get to the 100 % well, then I will be fine the way I am now. The only thing that really shocked me and disappointed me was that I have trusted my psychiatrist completely and then he goes and gives me a medication that would actually harm me. And that is a fact confirmed by the manufacturer. I need to inform him but don't know how. I have been postponing it from one day to another. Do I show disappointment, do I just tell him without showing any feelings,...? And the big question, how can I trust him anymore? Thank you a million for answering me. I appreciate it a lot. My best to you and your sweet cat. 😸😻

777Q

Date posted: 35w

Perhaps quietly seek out another doctor that you might have better chemistry ⚛️ with. Also consider the DNA mouth swab test to check for medication compatibility if you haven’t done so already. My little cat 🐈 is bestest behavior, she doesn’t want coal in her Christmas 🎄 stocking , LOL ! How are your 3 fur babies 👶 doing?

NODA

Date posted: 35w

Well,... that is a problem. There are only two psychiatrists in our region, and the other one is an inexperienced young woman with lack of knowledge and doesn't know how to communicate with patients. First hand experience. My now doctor is her mentor. There are some psychiatrists in our general hospital, but only for the inpatients, those who ended up in the emergency because of a failed suicide attempt or after being injured in a fight,... The other psychiatrists are just too far away for me to be able to be their patient. I am basically stuck with him. It's him or nothing. So how do we go on? I need to tell him about the whole medicine mess. I wish I knew how. With what attitude? People usually are nice as long as you praise them and agree with them. As soon as you show dissatisfaction or a difference of opinion, you become a pain in the butt for them. And they show it. I am very interested in the DNA mouth swab test that you mentioned. Could you tell me some more, please? Where can one do the test? Is it covered by insurance or you pay it yourself? Approximately how much is it? I am not sure if the test is also done here. I have never heard anyone mentioning it. I would really like to do it. It would help immensely, I believe. Bravo! 👏🎅to your little cat. Maybe she could talk to one of my cats. The boy has turned back time and is behaving like a spoiled rebellious teenager. 🤣😸. The girls are like your cat. Calm, quiet. They just want to cuddle and rest. The boy is like Cato Fong in the films The Pink Panther. Cato is Clouseau's Chinese manservant, hired to attack him regularly to keep him alert and skilled in martial arts. Except that my cat is not hired by anyone to stalk and attack the girls. One moment he is nowhere to be seen, the next I am trying to catch my ballance and not fall because he somehow appears between my feet, or behind me or just in front of. And it is always in a split second. I honestly don't know how he does it. My cats are all indoor cats. Just as an example : We are all in a room. The door is closed. I look everywhere. I see the girls, he has vanished. I turn around and there he is just as I start my next step. When I open the door and he has access to all the rooms this becomes an adventure. You never know where he is lurking from. 😸😁😻. I don't think he cares much about Santa's opinion about him. 🤣🤣. I love him soooo much. All of them. They bring me joy, laughter, happiness and calmness. I do my best to make them know how much I appreciate them. I get your baby is also a precious treasure to you. 😻 My kitties say hello to both of you and so do I. 🤗😻

777Q

Date posted: 35w

Genesight is a lab company that does the test . On the bright side only have to have it done once and done since DNA doesn’t change . It is expensive, had it done 10 years ago , I discovered 85 % of medicines I am not compatible with .

777Q

Date posted: 35w

If I recall it was out of pocket as far as the expenses were concerned.

777Q

Date posted: 35w

My little one does get under my feet at times when she is feeling “ clingy “. I tell her under the feet again no good will come of this for man or cat if I trip and fall on top of you , LOL !

777Q

Date posted: 35w

You have an excellent full of life personality with a good sense of humor. You are right no one likes to hear things that are at odds with what they want to hear . With the doctor I probably would lead with how it was appreciated all that he knows and does for you BUT than I would state my concerns . That still could rock the boat though .

NODA

Date posted: 35w

Hi. Thank you for all info. I will definitely check it out. Wow 85%. That is a lot. Me too, I tell my cat the same thing every time he sees me either as a scratching post or a bowling pin. Doesn't make much of a difference. When he decides it's party time, it is party time for all of us. For some more fun than the others. For some it is just time to try to survive. 😸🤣😁. Thank you for your nice compliment. And for your suggestions about my psychiatrist. You know what, I agree. I will do exactly that. It includes both respect towards him and fairness for me. And then it's up to him how he reacts. That is out of my hands, right. I wish you a great Sunday. You're great. 😻💞

mandeebobandee

Date posted: 25w

Really Struggling

I feel like I'm up against an insurmountable mountain. I'm not new to OCD; I know I've had symptoms since at least the age of 8 (probably earlier to be honest, I just know things really took off when I was 8). I dealt with things with no outside help until I was 17, at which point I began seeing a therapist and began to take celexa. I stuck with that therapist for a couple more years before going about my life, though I continued to take the the celexa. Fast forward to 2018, age 29 - I once again began to see a therapist and had my meds adjusted once more, this time switching to Luvox. I also wound up switching therapists after a year or so, though not by choice - my therapist had a personal crisis come up that necessitated the switch. I still see the same therapist I switched to in 2019. Early 2020 brought with it a couple more med changes, going off the Luvox and onto Cymbalta and Intuniv due to concerns about previously undiagnosed ADHD. This was how things were for five years. I'm not going to say things were perfect- there were undoubtedly bumps in the road - but things felt doable, and I mostly found enjoyment in life. This came to a screeching halt recently. Again, as I said, there were bumps in the road. At first, I thought this was all that this was. When I spoke to my psychiatrist in early February, I started Ativan as I just wanted something to take the edge off a little bit. I also went off of Intuniv as we thought that might be contributing to things. It was Saturday, February 8th when things really started to go off the rails. My boyfriend and I were going on a short trip across the state. An intrusive thought popped up - What if I sleepwalked at the hotel and hurt or even killed my boyfriend? This fear stuck with me through the entire trip. I heaved a sigh of relief as we drove back. I'd soon be safe back at home and I'd put it all behind me. If only. On the ride home, my worries shifted to concerns that I would sleepwalk and do something to my parents, who I live with. I fretted for the majority of the trip back, already making up plans to research the subject and how unlikely it would be that something like that would happen, and I'd tell my parents for good measure. They, of course, assured me that I'd never sleepwalked in the past so it was unlikely I'd do so now. I should also note that this is not a new fear of mine, but one I experienced as early as elementary school, though it had essentially disappeared up until this point, decades later. If only it stopped there. I stopped taking the Ativan Sunday evening in the middle of the trip, my thought being that the Ativan might have contributed to this. My boyfriend, in fact, had a reaction years ago where Klonopin actually sent him into a panic, so it seemed possible that I might be experiencing some sort of paradoxical reaction. I also remained off of the Intuniv. Monday was the day I began experiencing loss of appetite. Monday was also the day when things really began to take off and my life began to truly feel like a waking nightmare. Another horrific image from my past reared it's ugly head - an image of my grabbing a knife from the kitchen and stabbing my mom. An image that has continued to haunt me since - and now its 2 weeks later. There's still a bit more to the story - The day after this began, I went to a local urgent care. I was now not only experiencing these horrible thoughts, but I could barely eat lunch, and my stomach was hurting. I also told my parents the latest turn in how things were going. From the urgent care, I was given a prescription for Omeprazole and Hydroxyzine. The following day, I went to my ordinary doctor's office, where the doctor suspected my increase in anxiety and the associated intrusive thoughts had to do with going off of the Intuniv I'd been taking for five years without tapering, and advised me to immediately resume the Intuniv. He also endorsed continuing the Hydroxyzine, which I was taking at night before bed at this point. I'd hoped that going back on the Intuniv would 'even things out' and I'd be back to normal in no time. The thoughts continued, unfortunately. I had an appointment with my therapist as well as my psychiatrist, who upped my dosage of Intuniv to 3mg instead of 2mg and advised on other medication options should this not help. Though I would like to see both of them more, it's difficult with my work schedule and their busy schedules to find time. As of right now, I'm seeing my therapist once every two weeks. My next appointment with her is this Wednesday. I've also made follow up appointments with my regular doctor's office. Last Wednesday (2/19), I had an appointment with an NP who advised I take the Hydroxyzine three times a day rather than just at bed time, so I've been doing that. I thought it might be helping the first time I took it in the afternoon, though this doesn't seem to be the case with subsequent dosages, unfortunately. I also see her again on Wednesday. I apologize for the long post, but I wanted to share how I got to this point. Things aren't great. I'm trying to enjoy life where I can - I recently played board games with my parents yesterday and went to a restaurant with my boyfriend the day before and felt almost normal, but even in those instances it felt like there was something lurking just beneath the surface. I'm going through life, but it feels like I'm barely surviving. I'm going to work but only because I think I'd be worse at home with absolutely no distractions. I wish there was a switch I could flip and things would be back to normal, where I didn't feel this way. In fact, more often that not, I want to be laying in bed asleep, because you can't think when you're asleep, and it feels like the only refuge at this point. It's hard because home was always my safe place, and my mom one of my safe people - and now this. Anyway, if you made it through this long post, thanks for reading. <3

Harm OCD

Anonymous

Date posted: 24w

Medication Questions

Hi all! I am on Zoloft 100mg and I was hoping to get some feedback! My biggest fear is being suicidal and sometimes I’m like checking to see if I am suicidal on the medication but then I think maybe it’s my ocd. My doctor wants to go higher but I’m wondering if this is a good idea based on my thoughts. Any feedback would be greatly appreciated!

Lena1998

Date posted: 22w

Harm OCD made worse by psychiatrist visit

I went to talk to a psychiatrist based off my Nocd therapists recommendation. I had a very hard week beforehand where I had anxiety so bad I couldn't leave my bed. It seems like once I get my period my anxiety and everything dissipated some so I talked to the psychiatrist. Anyways, I was immediately put off by her because she told me she didn't have any information on me included in the referral for one reason or another. So I had to basically "fill her in" on my life story. I have anxiety disorder, panic disorder, OCD and PTSD. I told her these things and how hard the last week had been. She started asking questions like I had bipolar disorder, which I don't have. She then wanted me to take buspar and Zoloft TOGETHER daily. I know for a fact you never start two medications daily at once. You don't know which one is causing symptoms if you do. So I immediately didn't like that. I asked her about Zoloft specifically daily because it is an SSRI what I should do if it gave me thoughts of harm for myself. She told me "just go to the hospital".... Now, I don't wanna say that was the worst possible thing she could have said to me, but it was. Because now my OCD is spiraling that just my general harm OCD thoughts are enough to mean I need to go to the hospital. It had been 2 days and I cannot stop obsessing that maybe I'm depressed or suicidal because of this. I know I don't want anything to happen to me. I love my family and my friends. I am scared of death. But the thought is sticky and it's been so, so frustrating. My anxiety has been so frustrating. I feel so lost and like nothing I'm trying to fix my issues is working very well. NOCD therapy has been one of the only things to help in the long term, but I still get terrified of certain obsessions like suicide. I don't really know what to do, if anyone has any advice or any personal experience that may help, anything would be nice right now. I've felt so lost trying to figure it all out.

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