[circles5]

Hi all,

i've so far had terrible luck with SSRI's..
I've been on:
Fluoxetine/Prozac @ 40mg for 6months,
Sertraline/Zoloft @ 100mg for 2/3 ~ months.

^i had pretty extreme reactions to both..
But in hind sight, Prozac did help my BDD,,, whilst sending me pretty crazy.
And Sertraline, just depressed me (emotional emptiness), didn't really help with my OCD, And sent me a bit crazy to boot as well.

Now, i'm not too keen on trying any of the other SSRIs..
I hate the: 'Wait 2+ months to see if it's going to work, then start again' ethic.
For this reason i tried Mirtazapine, and it helped my depression seriously quickly, but it also completely knocked me out.. -
i was unconscious for most of the day…. (literally 16-18hours sleep a day.)
So i had to stop Mirtazapine.

So seeing as Prozac is indicated as the best for Body Dysmorphic Disorder,,
And i kind of remember it helping……(it was five years ago, pre-therapy… kind'ove foggy)
then maybe i should give it one more try…..

i don't know,
I'm already on diazepam 12mg a day, so that's a plus… should help with the going on and off,,
-----

It's just; i think my BDD has gone haywire, and i'm seriously not coping with it very well… at all.
But i am so, weary of what the SSRI's did to me,, they really drove me a bit - weird,,

I know this is something i've got to decide myself..
but seeing as i'm not in touch with a psychiatrist, i don't really have anyone 'in the know' who could suggest what they thought was appropriate..
I've got a couple more sessions with my psychotherapist - But she can't advise me on medication,, it seems to be a rule that only psychiatrists can, or G.Ps…
so that leaves my only option: G.Ps.. - who prescribed me the SSRI's in the past… but weren't very forthcoming about possible side effects,
and didn't believe me nor help when there were.

I really would, in an ideal world; taper off diazepam - and tackle things using my CBT and, probably more therapy; {sadly with a different therapist.}
But i don't know if i can get over this..
I've got BDD, really bad.

Thing is,,, i don't think i could fix my Body Dysmorphic Disorder in 12~ sessions with a psychotherapist.. - and that's all i would be able to afford,, absolute maximum.
So i need to do something to help me cope, as i can't stand still being in this situation…

Cheers,
Circles5

[sewerrats]

your going to be sleepy on a ssri when taking valium to, you can do an online CBT course without getting out your chair . Its the same course has the hospital only there is only you there If your only taking SSRI for 2 weeks before giving in no use trying another there all the same for a at least 5 weeks or so . They make you sick has a doc till they kick in, unless straight taper overnight from 1 you have been on a long time, to the same class of med.

[ChangingMyMind]

That's a tough situation you're in but something has to give at some point. Not all SSRIs are equal, as I am sure you know. Celexa was great for me but Lexapro wasn't helpful at all... And they're supposed to be similar. It's weird how drugs work for different people. I would say get a genetic test if you can. I didn't have great luck with it but it at least gives me the piece of mind that I'm trying drugs that my body might metabolize well.

If that is not feasible then if I were in that position I would definitely try a different drug but maybe a different kind of AD. Have you tried SSNRIs? Those might be better for you. Although would be best to talk to a pdoc about it first even if that means getting an appointment with a new one. It's better to have their guidance as they are the pros.

Hang in there and don't give up because medication can help take the edge off and even if it's just a little, if the side effects are not bad, it could be worth it.

[circles5]

Originally Posted by sewerrats

you can do an online CBT course without getting out your . Its the same course has the hospital only there is only you there If your only taking SSRI for 2 weeks before giving in no use trying another there all the same for a at least 5 weeks or so

Hey sewerrats, i'm a bit apprehensive about an online test, for instance i find the Yale Brown Ocd Checklist a Mine field.
'So are they asking me if i x.x.x.x. or is the question actually about x.x.x.' e.t.c

It's that 5+ weeks… that annoys the hell out of me. As you go through all the worst of the side effects, to find out; oh, it didn't work.. damn.
And then switching directly over, seems like you'd have both in your system, and without a period of abstinence it would be hard to tell one from the other, from un-medicated for a while.
So i tend to just try one, and then come off it (cold turkey normally - i know bad idea…)
Then i tend to leave a year or so, and then get desperate and try another.
The only medication i took for a very short time was mirtazapine, and that was because i was informed that the sedation wouldn't really alleviate.. so i jumped off it.

Originally Posted by ChangingMyMind

That's a tough situation you're in but something has to give at some point. Not all SSRIs are equal, as I am sure you know. Celexa was great for me but Lexapro wasn't helpful at all... And they're supposed to be similar. It's weird how drugs work for different people. I would say get a genetic test if you can. I didn't have great luck with it but it at least gives me the piece of mind that I'm trying drugs that my body might metabolize well.

If that is not feasible then if I were in that position I would definitely try a different drug but maybe a different kind of AD. Have you tried SSNRIs? Those might be better for you. Although would be best to talk to a pdoc about it first even if that means getting an appointment with a new one. It's better to have their guidance as they are the pros.

Hang in there and don't give up because medication can help take the edge off and even if it's just a little, if the side effects are not bad, it could be worth it.

thanks, I'm very interested about this genetic test,
I'll have to inquire with my G.P on that one.

I've yet to try a SNRI, (is that the class you meant?) i got put off by reading posts about Effexor, and how 'full on' it is..
But bar the trycillics - it's the class i've yet to try.. (as far as i'm aware)
So i may opt for an SNRI.

- i've not been in contact with a Pdoc for a long time,, i've been having psychotherapy, and it's video'd - i think so the sessions can be reviewed by the 'team' if necessary..
But i haven't seen an actual psychiatrist in several years.. (apart from in hospital actually, now i remember.. and she suggested clomipramine… i said hell no. - she was not a good Pdoc…
(50% benzo reduction overnight from high dosage… and five day taper from 100% to 0%)
^she only got me to 50% thankfully, before shift change mid week..

But, i think i'd have to go privately to see a PDoc,, and i'm worried how much that might cost.. (i'm in the U.K,,, everything has been free so far.. and i'm pretty broke)

Thanks for the advice

Regards
C

[-jimi-]

If you have obsessions I'm a little surprised they have not suggested luvox.

[circles5]

cheers jimi…

I do have obsessions, But my OCD is pretty under control now.
It's the BDD that has really got out of hand.

although i'm still finding it weird that BDD is now classified under the new:
'obsessive-compulsive spectrum disorders'

^since the dsm-v

i feel like it is more than obsession related,,

[sewerrats]

Originally Posted by circles5

Hey sewerrats, i'm a bit apprehensive about an online test, for instance i find the Yale Brown Ocd Checklist a Mine field.
'So are they asking me if i x.x.x.x. or is the question actually about x.x.x.' e.t.c

It's that 5+ weeks… that annoys the hell out of me. As you go through all the worst of the side effects, to find out; oh, it didn't work.. damn.
And then switching directly over, seems like you'd have both in your system, and without a period of abstinence it would be hard to tell one from the other, from un-medicated for a while.
So i tend to just try one, and then come off it (cold turkey normally - i know bad idea…)
Then i tend to leave a year or so, and then get desperate and try another.
The only medication i took for a very short time was mirtazapine, and that was because i was informed that the sedation wouldn't really alleviate.. so i jumped off it.



thanks, I'm very interested about this genetic test,
I'll have to inquire with my G.P on that one.

I've yet to try a SNRI, (is that the class you meant?) i got put off by reading posts about Effexor, and how 'full on' it is..
But bar the trycillics - it's the class i've yet to try.. (as far as i'm aware)
So i may opt for an SNRI.

- i've not been in contact with a Pdoc for a long time,, i've been having psychotherapy, and it's video'd - i think so the sessions can be reviewed by the 'team' if necessary..
But i haven't seen an actual psychiatrist in several years.. (apart from in hospital actually, now i remember.. and she suggested clomipramine… i said hell no. - she was not a good Pdoc…
(50% benzo reduction overnight from high dosage… and five day taper from 100% to 0%)
^she only got me to 50% thankfully, before shift change mid week..

But, i think i'd have to go privately to see a PDoc,, and i'm worried how much that might cost.. (i'm in the U.K,,, everything has been free so far.. and i'm pretty broke)

Thanks for the advice

Regards
C

The in with a new med and out with an old works better on ssris than detoxing and starting up that takes months this is over night, but that one is up to you. CBT mmmmmm works for some but a mystery to me , I just don't get it , and neither did %80 of my class , but this is a England

[Altered Moment]

I think it is worth trying an SSRI again. I don't know anything about them being better for BDD. Is that what the clinical data is suggesting?

To bad the mirtazapine was so sedating for you. I take it at night and only get 4 good hours of sleep out of it.

I am afraid that is the route we all have to take. Start a med, wait six weeks to see if it will work and if we get over the side effects.....if not next......thats just how it is. With me pdocs have always started the new one right away and pretty quickly tapered me off the old. I know the UK doesn't do it that way.

The thing is even with the SSRI's each one can be so different and each one of us can be so different.

There is also the SSNRI's and Wellbutrin. Thats about it.

SSNRI's
Effexor
Pristiq
Fetzima
a few others that are not very popular.

I am currently having very good results with Fetzima. Very activating for me. The SSNRI's are supposed to be activating but Effexor and Pristiq were not and yet Fetzima is......its a crap shoot.

[ChangingMyMind]

Originally Posted by circles5

thanks, I'm very interested about this genetic test,

I'll have to inquire with my G.P on that one.


I've yet to try a SNRI, (is that the class you meant?) i got put off by reading posts about Effexor, and how 'full on' it is..

But bar the trycillics - it's the class i've yet to try.. (as far as i'm aware)

So i may opt for an SNRI.


- i've not been in contact with a Pdoc for a long time,, i've been having psychotherapy, and it's video'd - i think so the sessions can be reviewed by the 'team' if necessary..

But i haven't seen an actual psychiatrist in several years.. (apart from in hospital actually, now i remember.. and she suggested clomipramine… i said hell no. - she was not a good Pdoc…

(50% benzo reduction overnight from high dosage… and five day taper from 100% to 0%)

^she only got me to 50% thankfully, before shift change mid week..


But, i think i'd have to go privately to see a PDoc,, and i'm worried how much that might cost.. (i'm in the U.K,,, everything has been free so far.. and i'm pretty broke)



Thanks for the advice


Regards

C

Yes I was referring to SNRIs also called SSNRIs. I didn't know you were in UK, I know things are done very differently there. In that case I would go by whatever your GP suggests. I am not too familiar with BDD but if you're looking for medicine to help with any mood disorder it really is a game of trial and error. I am not sure if they do the genetic testing in UK, the test itself is around $4000 but if your insurance covers it... Great! If not then the company that does the testing does have a financial assistance program but I am not sure if that is applicable outside of the states. Worth asking about though.

Best of luck to you!

[circles5]

@sewerrats
I've found CBT to be pretty well suited to me, but i really need it drilled into me..
I have been reading a book of self treatment for OCD, but even though it's incredibly concise… it takes me a while to absorb it..

that's why i much prefer seeing a psychotherapist one 2 one… as they can explain something to me very quickly, that i could spend hours -
trying to get my head round..
however the book has been a solid resource for information and self-help..

It's appealing to me to try; 'back to back' trials with meds, to hopefully find the one that works for me… but the idea of feeling different every month ~ is quite daunting..
thankyou

@zinco14532323
Oh,,, well wikipedia used to say Prozac was the first line medication for BDD,, but now it doesn't - so i'm not too sure anymore - So, i guess i don't really know if SSRIs are still considered the first option,, - i'll have to ask a doctor i guess?
Yeah, the doctors over here in the U.K do seem to just doll out one med, see if it works and then if not, leave you without anything for a while… - which i suppose has it's ups and downs… -> but if i am to find the right medication,, i don't want it to take months per single medication e.t.c. -> that would be too much.
So i'd opt for back to back if they'll let me.. (unless i strike lucky and find one that works for me straight up)
Glad Fetzima is working for you,
cheers zinco14532323

@ChangingMyMind
I normally tell my G.Ps what's up, and they put me on a course and leave me to it..
It was: 'i have BDD' - heres prozac,,,, 'my ocd is bad' - heres zoloft,,,, 'i'm depressed again' - mirtazapine…

So i'm going to try and get a psychiatrist.. - i've only ever been diagnosed once, and i'd like to see if anythings changed..:
I was diagnosed when i was 20 with: OCD, BDD, GAD and depressive episode.
i keep getting recurrent depressive episodes,, which i'm not surprised about, but i'd like to get re-evaluated..
Plus it'd be great to have someone trained in psychiatric medication and with a knowledge of anxiety and depression to choose a medication - and then see what happens to me.. and whether they think it's working..

Unfortunately $4000 is way out of my budget, and the NHS won't pay for that. Sounds cool though.

Thanks again.

--
--

Appreciate all the advice
Have a good night all.
C

[onionknight]

I can relate--I had bad reactions to both ssri and snri, unpleasant on them, torture getting off. I'm probably still in the withdrawal phase, but I have torturous obsessive thoughts that make every things like work and driving awful. It crosses my mind occasionally that I might want to consider taking another med.