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Advice needed: Meds for trichotillomania SSRIs not an option

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I have bulimia which I can reasonably control, some general anxiety - also not too bad but I've had trichotillomania for several years & now it's really bad. I've tried two SSRIs Zoloft & Lexapro 50mg & 10mg but the nausea side effects of both were so bad that I couldn't keep taking them as they were causing a serious bulumia relapse.

I am seeing the doctor soon & the two main side effects I cannot deal with are nausea & weight gain. Is it worth trying any of the a-typical anti-psychotics as the seem to all cause weight gain? I've tried Seroquel 25mg and it just made me insanely hungry but not sure if the dosage needed to be higher.

Am considering an MAOI like Mannerix but people seem to say meds for tics and tourettes work well also - any advice at all would be so helpful. Finally I live in Ireland so some drugs you guys have aren't available here & my doctor needs me to educate her - most doctors here really don't know much about trich.

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My sister has had some luck with a tricyclic antidepressent.... i can't remember the name of it but it definitely works. If I find out the name I'll let you know. Sorry.

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One brand name for nortryptiline is Pamelor.

Has your pdoc decided to eliminate SSRIs from your cocktail altogether? There are more SSRIs to try, and sometimes only a specific one will work for a person.

But if your pdoc has decided not to try more SSRIs: You cannot choose medication based on possible side effects. The fact that a side effect is listed on the PI does not mean you will experience it. You don't know if you will gain weight on AAPs, and there are some that have less of a reputation for weight gain.

Have you ever taken aspirin? One side effect is death, but it doesn't happen very often. It looks like you haven't experienced that side effect (I am assuming you have taken aspirin, obviously). That is true for a lot, if not most side effects.

If you are going to eliminate entire classes of medication because of potential side effects, it is going to be hard for you to get well.

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I know you probably aren't reading the other posts, but you are at least the fourth person in as many days that crtclms has posted the same response to. Heck, even I wrote a similar response yesterday!

I took many meds that had horrible potential side effects. Sometimes I got some side effects, but most of the time I've experienced no side effects. And in seven years of treatment, I've had more than 40 med changes/adjustments. So people here really know what they are talking about.

You have to realize that your worry and anxiety is part of your anxiety disorder, not because there is a realistic reason to fear meds so much. And if you take the proper med for you, your anxiety will get better.

As for side effects, most if not all go away after you adjust to the medication. Nausea is common the first couple of weeks. Invest in some mylanta or see your GP for a short-term anti-nausea med.

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Hey everyone, thanks so much for your kind replies. It was so nice to see so many replies. Here in Ireland doctors don't really like "medicating" and are often against SSRIs totally, they rarely prescribe benzos as they just go on about how highly addictive they are. I'll look up the names mentioned and suggest them to her, unfortunately I basically have to tell her what I've researched and ask for the drugs. I've switched doctors 3/4 times recently but doctors here don't like the cocktail idea and don't see trich as a real problem. Like I was refused the anti-psychotics the first time I asked because of the off label thing.

I don't see a Pdoc, I see a counsellor who I think can't prescribe meds I dont think, I think from reading other topics I should ask to be referred to see a pdoc & tell them everything & see can he prescribe me a few things to try and make a difference. As it's a general practioner who I see for prescriptions = regular doctor.

Also re the SSRI I hate to say I cant try any more but I've struggled for years with bulimia which I barely have under control at the moment & when I take them the nausea feeling just makes me induce vomiting up to a few times a day so it's a bit of a catch 22... I think I'm like 100 times more sensitive to nausea because my body is trained to vomit or something

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