OCD and Prozac

I have contamination OCD and was put on prozac about 7 weeks ago...I started at 20 mg and went up 20 mg bi weekly....I have now been on the 80 mg for a week, and my depression has lifted but the prozac has yet to affect the OCD thoughts and compulsions. It is easier to deal with the OCD having the depression gone, but I still want the OCD to get better.....how long does it take to work once I am at the highest dose.....when do I throw in the towel and try something else? My Psychiatrist also said I could add abilify at anytime if I wanted, but I wanted to a wait a bit to see what the prozac did. Anyone with OCD have experience with prozac...or abilify with prozac? Thanks!!!

For me it got a little better on Prozac on the max dosage. But I couldn't deal with the side effects. I'm on Luvox now and it helps a lot, on a low dosage. It seems to be a hit and miss for depression though, I also got good help for depression on it, all don't get that. Was the 29th med I tried so I think I deserved some luck and getting both symptoms treated.

Prozac had quite bad side effects for me unfortunately.

I'm so happy to hear that you have some relief with Luvox....that will be the next one I try if prozac doesn't cut it. Would you mind sharing with me the difference you felt with your OCD at the highest dose of prozac vs. the low dose of Luvox? I am trying to gage how much better I should feel with the "right" medicine. I haven't had any bad side effects with prozac....some problems with sleeping for a few days and occasionally slightly jittery but NOTHING bad at all. For that, I am grateful Thank you so much !

I would say max dosage of Prozac cut abt 25 % off my symptoms while second smallest dosage of Luvox (75 mg) cut 50 % of them.

So for me Luvox was the big winner here.

But we have different brains and we might react very differently.

Great, thank you! Good luck on your journey...I wish you all the best.

Luvox probably has the best reputation for OCD. It can have some sedation side effects, but it's really effective for OCD. Clomipramine is a TCA that is probably the best studied med for OCD, however SSRIs are preferred because they have lower toxicity. Atypical antipsychotics, primarily risperdone and zyprexa show some efficacy when augmenting SSRIs. I'm not aware of any studies using abilify, but that doesn't mean it wouldn't be beneficial.
Good luck. Hope you find something that works.
If it's been 7 weeks and no results, I'd try something else if it was me.

Hi! Thank you for your reply! I have only been on the highest dose of 80mg for a week though...would you still thrown in the towel, or give the high dose some more time...thanks again!

Prozac takes at least 6 weeks to reach theraputic levels for most people. I'd stick w that 80 dose until then and decide.

Good luck,

moogs

If no real side effects I would probably wait it out to see if it gets better. If it doesn't after that time I would wonder about a new med. I was once given an antipsychotic for this and depression and it was a disaster. They tried antipsychotics on me in the past and for some reason I just don't tolerate them.

My opinion and just my opinion, I'd give it another week, maybe two and then throw in the towel. Honestly, if it was me, I'd consider talking with my doctor about changing now. Recent studies show that if people are going to have a positive effect to a med, there's usually an effect within the first two weeks, sometimes up to 20 days, but it rarely takes the full 6-8 weeks previously thought to see a therapeutic effect. Like you said you noticed an antidepressant effect within a couple weeks? That's typical. There's occasionally a delayed effect, but it's much less common than previously thought. It's less likely, not impossible, but less likely, that the increased dose will do anything for the OCD if it hasn't already by now. If it was going to work, you likely would have already had a partial response.
I guess you kind of have to make a decision of which is more debilitating, the OCD, the depression? Do you want to be on two SSRIs, do you want to try an atypical antipsychotic? I'd be kind of interested to see how you would do on clomipramine. It's a TCA. It's good for depression and OCD. It's actually more potent than Prozac on serotonin, dopamine and norephinephrine receptors. Just some ideas. Maybe something to discuss with your doctor. Good luck. I really hope you find something that works for everything for you.

I wouldn't recommend clomipramine to my worst enemy. On really low dosages it might be OK, but usually with these issues you go on max dosage. It dries out your mouth (like totally), can dry out your eyes and create scars on your corneas, it can make it almost impossible to pee and also you might get constipation. Plus a general feeling of being sick and weak. There is a reason these meds are not used anymore.

I'm on clomipramine and I don't have any side effects at all.

Very lucky for you. I was on 200 mg / day.