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Anxiety and OCD


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Hi, I was switched to Depakote, 1000 mg, almost two weeks ago. Strangely, I am feeling less depressed. Not great, but, a little better. I'm still having anxiety and OCD. I was wondering what meds to talk about with my pdoc at my next appointment which would work inline with my bipolar diagnosis.

 

Latuda didn't work, antidepressants make things worse, not a fan of long term benzo use, so what are my options. Seroquel?

Edited by natatatt
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I've had good results taking a low-dose of Trazodone (100-125mg). I don't take SSRIs anymore because they push me into hypomania. My experience has been that higher doses of Trazodone have knocked me on my butt by making me feel hung-over the next day. A very similar feeling to have drunk way too much booze the night before, without the dry-mouth, heaves, or other alcohol poisoning symptoms. I had to get to my low-dose slowly.

The Trazodone helps with these anxiety symptoms I have: Social anxiety, hyper-vigilance, internal aggressive feelings, avoidance, and intrusive thoughts.

My OCD is probably a minor comorbidity-type-of-thing in my case, so I can't say that Trazodone has been highly-effective for it, but for what OCD symptoms I do have, the Trazodone has offered some noticeable relief.

Trazodone is a much dismissed medication, though, because it's dated and considered a weak anti-depressant/anti-anxiety medication, so your physician may say "nah" right away. For me, though, it has been a real help with some of the more intractable anxiety symptoms that I've described. It isn't super for my actual depression, but even so, it has some minor effectiveness for that. I'm still looking for a better anti-depression medication to combine with Trazodone. Most physicians prescribe Trazodone as a sleep aid (off label), so they may look at you funny if you bring it up.

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Neurontin (gabapentin) is sometimes used for generalized anxiety. I have no idea how it works for OCD though. It's an anticonvulsant like Depakote, but it is not nearly as hard on the liver. It does not make a good mood stabilizer though. I believe you can take it in addition to the Depakote, but I am not a doctor so I'm not sure.

 

I think I know what you mean when you say you feel less depressed on Depakote. I feel the same way on carbamazepine (Tegretol).

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I have had a good experience in the past with Abilify (Antipsychotic);

 

I have took it for 4 years and was able to graduated from University. But to side effects (neurological issues...) must stopped it... 

 

For me it did this:

  • Lift my depression up so I was between normal and hypomanic state.
  • Less fear and anxiety 
  • It's less sedating then other AP's and also works good for the down side.
  • Better concentration.

Note: Some people find Abilify a little bit stimulating, so always be careful and tell all things to the pdoc.

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I have some anxiety that tends towards the OCD end of the spectrum when I get manic-y, and when I'm depressed I have agitated depression (wee!).  I really like Seroquel, I take it daily - well, nightly.  I also take gabapentin as needed for anxious days and really like it.  I have PMS this week and woke up just feeling edgy and barking orders at my family and took a gabapentin and immediately felt that edginess fade away.  I also like my lithium for the agitated depression, which is more anxiety than OCD.  My meds right now are awesome.  I went on them all at very separate times though so I can honestly tell you they all work for the anxiety aspect of my bipolar disorder.  Any SSRIs make me feel like I am coming out of my own skin.  I just can't do a one of 'em.  And I've tried them all.  Bummer.

Edited by ray_of_sunshine
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