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What are some OCD medications bipolar people can take?

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Hi everyone, I've been struggling with OCD for the better part of about two years, and something that's made its treatment a lot more complicated is the fact that I have Bipolar I.

I know that the first line treatment for OCD includes SSRIs and antidepressants, but I can't take any of those because there's a very high risk of mania. I'm also not a big fan of the idea of "augmenting" with SSRIs with a mood stabilizer, as my psychiatrist compares it to playing with fire.

Medications that I have looked into include Seroquel (makes me into a zombie), Buspar (apparently doesn't work; makes me drowsy), Memantine (trying now, mixed results), Inositol (apparently it can cause mania so I never tried it), and more.

Lately I've been looking into things like Lyrica, gabapentin, and riluzole, but I'm starting to get desperate because there's not a lot of stuff out there that's both A) effective for OCD and B) safe for bipolar people to take.

What do you all think? Do you guys know of any bipolar-friendly medications I could add to the list of stuff I'm looking into?

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Why don't you ask your psychiatrist what he would recommend?

I'm a little bit taken aback by what your psychiatrist told you because many people with bipolar are successfully treated with SSRIs once they are stabilized on a good mood stabilizer(s). It's not really considered augmenting. It's called treating the OCD. The mood stabilizer(s) is for the bipolar.

Other than that you might consider Risperdal or Invega because some people have luck with those. I did not, however. I also find that Abilify does not help with OCD.

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3 minutes ago, jt07 said:

Why don't you ask your psychiatrist what he would recommend?

I'm a little bit taken aback by what your psychiatrist told you because many people with bipolar are successfully treated with SSRIs once they are stabilized on a good mood stabilizer(s). It's not really considered augmenting. It's called treating the OCD. The mood stabilizer(s) is for the bipolar.

Other than that you might consider Risperdal or Invega because some people have luck with those. I did not, however. I also find that Abilify does not help with OCD.

I have asked my psychiatrist before what she recommends and the answer is usually "therapy" but therapy isn't helping fast enough in my case.

As for the "augmenting" thing, I myself am nervous about it because I'm worried that adding an SSRI would upset the balance that the mood stabilizers have made possible. The last time I tried doing something that affected the mood stabilizers, it was lowering one of them slightly, and that caused a psychotic mania.

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I'm in exactly the same situation. From experience, SSRIs are off limit, especially at the maxed out dosages that are needed for OCD.

I'm taking geodon. I was prescribed this in hospital for obsessive thoughts. My doctors insisted they had done some research into my situation, and that either geodon, latuda or ability would work. 

Results so far... I don't know. I was also experiencing psychosis at the time, and the geodon took care of that. It also took care of my obsessive thoughts for a period of time. Now they're back. My normal OCD rituals also never changed.

Your best option, honestly, is to find a really great therapist who can do exposure and response prevention therapy with you. That's what has helped me the most, not meds. Feel free to PM me if you like.

Edited by aura

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Anafranil and desipramine did not work for me.  This was while in college, and I was not in a pdoc's long-term care.  I was seeing seeing this pdoc to see if he could help in any way.  After those meds didn't work, I didn't go back (not because of those meds not working, but because he really screwed me over money-wise and for  a couple other shit reasons I won't get into here). 

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Ability really works for me in reducing the interesting thoughts. Not gone, but reduced. It may be a great way to make therapy more effective. My therapist tools me that a having the obsessions somewhat controlled made therapy tolerable enough that I could bear to do it.

Also, what kind of therapy are you doing? CBT/ERP?

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Lyrica is great for me. Sort of my saviour. Other SSRIs I have taken show more or less the same result. I really can't feel any difference when my psy switch meds for me. 

Effexor is one I really don't like. It makes me sweat like hell. Abilifi also has serious side effects on me which makes me pace n pace non stop. 

A good therapist will be a great help, although the result usually won't show overnight. If you have so many doubts, why not get a second opinion? It's better then searching the Net. 

 

Edited by Yoshimi Nagasaki

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Supposedly medications which antagonize glutamatergic neurotransmission are said to be good for OCD.

Medicines like memantine (Namenda), topiramate (Topamax), zonisamide (Zonegran), lamotrigine (Lamictal), riluzole (Rilutek), N-acetyl-L-cysteine (NAC, which you can buy OTC)... Some other medicines that might help are levetiracetam (Keppra), amantadine (Symmetrel), and Lyrica (pregabalin) (and for that matter, gabapentin (Neurontin) might work too).

Oh, apparently haloperidol (Haldol) is an NMDA antagonist too, but you might not want to start reaching for that first thing for OCD. Magnesium is a natural NMDA antagonist I think I've heard, and zinc has antiglutamatergic properties about it too I think (at the NMDA receptor too).

Don't know if any of these links will be of any help since I'm more or less skimming through them to see if they're mostly relevant lol, but here should be some helpful links to support this.

Memantine
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085808/
https://www.ncbi.nlm.nih.gov/pubmed/19142108

Topiramate
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4543099/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274576/
(couldn't find anything on monotherapy with topiramate... only augmentation)

Zonisamide
(couldn't find anything for it... sorry :( )

Lamotrigine
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418246/
(again, it's not talking about monotherapy, only augmentation)

Riluzole
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958461/
https://www.ncbi.nlm.nih.gov/pubmed/26214725
https://www.ncbi.nlm.nih.gov/pubmed/15993857

NAC
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4423164/
(appears to need really high doses)

Levetiracetam
https://www.jscimedcentral.com/Psychiatry/psychiatry-3-1045.pdf
(However, it seems levetiracetam may induce obsessive-compulsive like symptoms in some people, so you have to be careful with this one. Personally I take it and find that it benefits my OCD and Tourette's syndrome slightly, but I'm on kind of a low dose.)

Amantadine (similar to memantine)
https://www.ncbi.nlm.nih.gov/pubmed/24824662
(Again, it's just talking about augmentation...)

Lyrica (pregabalin)
https://www.ncbi.nlm.nih.gov/pubmed/21460732

Gabapentin
(couldn't really find anything)

Hope this helps in some way! Good luck finding something to help you with your OCD!

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