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I was on Anafranil (clomipramine) for over a year, and it wasn't  controlling my OCD very well at all.........So I think I gave it a more than fair trial..

My pdoc has been tapering me off the Anafranil for a couple of months now, and yesterday was my last dose of it.

I've tried all the SSRIs except Lexapro and Celexa, so my doc wants to try me on Lexapro now for my OCD, and this morning I took my first dose.......She has started me out on 10mg and eventually wants to get me to 20mg, which is the max dose I think.

Why is the max dose so low compared to the other SSRIs....Anyone know?

Anyway, just started out on it and I'm skeptical because I've tried so many SSRIs that didn't work, but I'm trying to keep an open mind that this will help my severe OCD.

Are there any major start up side effects that I can expect.?.....I know there's always start up sides that eventually go away, but just wondered what others on this experienced.

And, is there anybody here with OCD on Lexapro?......Did it help?

Edited by CrazyRedhead
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Hey Redhead,
I'm about to ask my doctor for Anafranil (or Prozac, I don't know yet) ;-)
I've been on Lexapro for about 5 years. It's know to have a fast onset; for me it took only 3 weeks. I seem to become friends with SSRI's because side effects are very mild for me. Lexapro gave me restless legs at high dosages but more present was the teeth clenching and gnawing. I have an intrusive / stuck thought (with the obsession to get rid of it) so I can't say if Lexapro will work for the classic OCD with compulsive behavior like cleaning, counting, etc. 

I read somewhere about the maximum dosages of SSRI. I know 20 mg of Lexapro is as potent as 200 mg of Zoloft, but I can't rememby why this is.

The max dose is 20 mg though I've read from others that they've gone as high as 30 mg. I've been on 20 mg for some time and only dropped to 15 and later on 10 because I was in remission. 
Once at 5 mg I stayed there. After 5 years it suddenly stopped working...

I hope Lexapro will help you with the OCD! Good luck!

 

Edited by Catwoman
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@Catwoman, thanks for info.....Sorry to hear the Lexapro stopped working for you after that long.

I hope it helps some with my OCD, because I'm running out of med options for it......

Anafranil is supposed to be the gold standard for OCD, but did mostly nothing for me..........Hope you have better luck with it, if you decide to try it

Edited by CrazyRedhead
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Lexapro kicks in really fast and is a very potent SSRI, which is why it has lower dosages. They are equivilant to the dosing ranges of the other SSRIs.

I took Lex before I developed any OCD sx but it made me kind of numb and apathetic and killed my libido. 

Prozac helped a lot with my OCD sx. Cymbalta did, too but not so much anymore. I'm switching back to Prozac now actually.

i only get intrusive thoughts just FYI.

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I take Celexa which has the same psychoactive molecule as Lexapro, and it (together with some therapy I received) controls my OCD to the point where I'm comfortable in saying that I'm mostly recovered.

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I take Lexapro and it has been helpful to me. At work I walk up two huge flights of stairs multiple times every day and I haven't had the urge to count them once. I still marvel at that and I've been there three years. I've been on Lexapro on and off for depression (with BP2) for about 12 years but just started taking it consistently and without a break in 2013. I have been on 10 mg that whole time. 

Getting relief I got from my minor OCD was a pleasant surprise. I hope it helps you.

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14 hours ago, mcjimjam said:

Lexapro kicks in really fast and is a very potent SSRI, which is why it has lower dosages. They are equivilant to the dosing ranges of the other SSRIs.

I took Lex before I developed any OCD sx but it made me kind of numb and apathetic and killed my libido. 

Prozac helped a lot with my OCD sx. Cymbalta did, too but not so much anymore. I'm switching back to Prozac now actually.

i only get intrusive thoughts just FYI.

Lexapro made me a bit lethargic as well. My libido didn't change much, but I noticed the lack of motivation in the mornings. It's not a very stimulating med I suppose...

I'm still not sure...Prozac or Anafranil, but I'm glad to read that Prozac has helped you with intrusive thoughts since that is my issue as well. Lexapro worked fine for a long time....

@Redhead, I've been reading up on rTMS and OCD. It seems some people get good results from it. Have you ever looked into that kind of therapy?

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20 hours ago, mcjimjam said:

Lexapro kicks in really fast and is a very potent SSRI, which is why it has lower dosages. They are equivilant to the dosing ranges of the other SSRIs.

I took Lex before I developed any OCD sx but it made me kind of numb and apathetic and killed my libido. 

Prozac helped a lot with my OCD sx. Cymbalta did, too but not so much anymore. I'm switching back to Prozac now actually.

i only get intrusive thoughts just FYI.

Thanks so much for info..........Happy to hear the Prozac works for you.....Unfortunately it didn't work so well for me when I tried it....

 

13 hours ago, jt07 said:

I take Celexa which has the same psychoactive molecule as Lexapro, and it (together with some therapy I received) controls my OCD to the point where I'm comfortable in saying that I'm mostly recovered.

Celexa is next on my list to try if the Lexapro doesn't help........At that point I will have tried absolutely all of  the SSRIs...........

 

6 hours ago, theforest said:

I take Lexapro and it has been helpful to me. At work I walk up two huge flights of stairs multiple times every day and I haven't had the urge to count them once. I still marvel at that and I've been there three years. I've been on Lexapro on and off for depression (with BP2) for about 12 years but just started taking it consistently and without a break in 2013. I have been on 10 mg that whole time. 

Getting relief I got from my minor OCD was a pleasant surprise. I hope it helps you.

Glad to hear it worked out for you......I know it will take a few weeks to kick in, but I'm very hopeful it will help me out, too.

Edited by CrazyRedhead
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17 hours ago, CrazyRedhead said:

What is rTMS ?

https://www.verywell.com/new-treatments-for-ocd-2510610

It's a new treatment, but still experimental and it still doesn't work for every one. More research is needed and here in The Netherlands it's quite expensive.
There's a guy on my Dutch OCD board and he's keeping a diary while he is undergoing rTMS treatments. He is quite positive about his progress though it mostly helped with the depression and burnout.  The clinic is now going to try another area of his brain to see if this will effect the OCD-part of his issues. The treatments are combined with talk therapy and CBT; studies indicate this is more effective than rTMS alone.

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1 hour ago, Catwoman said:

https://www.verywell.com/new-treatments-for-ocd-2510610

It's a new treatment, but still experimental and it still doesn't work for every one. More research is needed and here in The Netherlands it's quite expensive.

Thanks...!!........Do you know if it's being done here (USA) yet?.......If not, hopefully it might be available here soon on an experimental basis as well.

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@CrazyRedhead Another idea to consider for treatment-resistant OCD is to combine Anafranil (clomipramine) with Luvox (fluvoxamine). You have to monitor the doses very closely because Luvox inhibits Anafranil's metabolism and can make it toxic if you don't start low and go slow.

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@browri, I have tried both Luvox and Anafranil separately, and neither one worked by itself........Combining both sounds pretty risky........Not sure I'd be willing to try it, and my pdoc might not agree.

I'm trying to keep an open mind, though, and I I did find an article:  https://www.ncbi.nlm.nih.gov/pubmed/8666564

According to article, sounds like people who are on this combination have to regularly have their blood monitored to make sure the Anafranil doesn't reach toxic levels, and also have regular EEGs and ECGs.

Edited by CrazyRedhead
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3 hours ago, CrazyRedhead said:

@browri, I have tried both Luvox and Anafranil separately, and neither one worked by itself........Combining both sounds pretty risky........Not sure I'd be willing to try it, and my pdoc might not agree.

I'm trying to keep an open mind, though, and I I did find an article:  https://www.ncbi.nlm.nih.gov/pubmed/8666564

According to article, sounds like people who are on this combination have to regularly have their blood monitored to make sure the Anafranil doesn't reach toxic levels, and also have regular EEGs and ECGs.

Actually that study that you found is what I was referencing. I do not personally know anyone on the combination, it was simply a suggestion. They both have different mechanisms of action but the effect fluvoxamine has on the metabolism of clomipramine is very intriguing and would theoretically make for a better combo than either would be apart.

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Well clozapine runs a much higher risk than other antipsychotics for agranulocytosis. Usually that is tried once other antipsychotics have failed.

Clozapine and loxapine are structurally very similar. They're from "cousin classes" Clozapine is a dibenzodiazepine related of course to the benzodiazepine class and loxapine is a member of the dibenzoxazepine class.

My intrusive thoughts are financial in nature. Obsessing over money. If I get into a fight with my partner, I obsess over the interaction in my head twisting it so many different ways to see how it could have gone differently. Thoughts of leaving him when it makes no sense and I'm actually quite happy. Intrusive thoughts of suicide on occasion. Loxapine made that all go away for me. It made me less obsessive, less of a worrier.

I started on 5mg at night, but that wasn't enough so I went up to 10mg. When Spring rolled around we didn't decrease my Prozac dose fast enough before spring mania hit and we had to go up to 25mg, but every time it has squashed my mania, racing thoughts, intrusive thoughts. It's pretty solid, and atypical at doses up to 50mg. But it can be dosed as a typical up to 250mg per day in divided doses. It's very sedating, which I can imagine Thorazine is as well, I just haven't tried it before so I can't compare. Just know that all of the dosing information you will find on loxapine says 50-100mg twice a day. You can take this 5mg and 10mg for "as needed" situations and use the 25mg and 50mg doses for continuous maintenance use.

EDIT: @CrazyRedhead Just wanted to add that I've taken Latuda, Saphris, Abilify, Fanapt, and Zyprexa. Most of them caused either akathisia from hell or weight gain (lookin at you Zyprexa). Loxapine is the first antipsychotic that I've tried that has virtually no side effects aside from morning sedation that also quells my mania and OCD-like thoughts. My pdoc says that he has a lot of patients on it. That he tries them on it after traditional ones like Risperdal and Seroquel have failed and most people really like it. Remember though, all these patients are taking low doses for the most part, 50mg or less. I seriously would recommend that anyone try it in combination with an antidepressant for bipolar disorder. I do still need oxcarbazepine to help with my anxiety and general jitteriness during the day but Oxtellar, Prozac, and loxapine together have totally knocked my BPII on its ass. I've never been happy with a med combination before and I legitimately am at a point where I don't want to change my medications, just adjust dosages. And this combination has all kinds of metabolic interactions that I can use to my advantage. Going up on Oxtellar induces 3A4 which would in theory slightly decrease my Prozac level but would also increase my exposure to one of loxapine's metabolites that converts into amoxapine (a tetracyclic antidepressant). Increasing Prozac would decrease my exposure to that metabolite but increase my exposure to the parent loxapine so more antipsychotic to compensate for the higher SSRI dose. Increasing Prozac though would also increase my dextroamphetamine exposure in Vyvanse which means a dose increase on Prozac could very well mean a hypomanic episode if I'm not careful. It's a game of "tuning".

Edited by browri
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On 2017-5-26 at 1:50 PM, CrazyRedhead said:

Thanks...!!........Do you know if it's being done here (USA) yet?.......If not, hopefully it might be available here soon on an experimental basis as well.

I thought it was a fairly known in the US for treating treatment-resistent depression.
http://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/home/ovc-20163795

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