I am suffering from severe depression, anxiety and panic attacks after losing a family member to covid. I also have obsessive compulsive disorder. I have been having serta 50 mg. Is this adequate?

Ankit GuptaPsychiatrist12yrs exp

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Dear Lybrate user, I understand it's difficult to cope up with loss of a loved one especially due to covid. It can push vulnerable individuals towards depression and anxiety on top of existing problems like ocd. Sertraline is a good medication for ocd, depression and anxiety disorders. However, 50 mg may not always be sufficient to completely control the issues. Most psychiatrists start sertraline at 25 to 50 mg dose with a plan to increase depending upon side effects and response to the medication and such increase usually takes 2-4 weeks depending on the urgency of situation. Also, some anti-anxiety medication are also added to temporarily handle panic attacks. If you don't feel adequately relieved with 50 mg, dose might need to be increased and add on medication may be considered. You can discuss with your psychiatrist who knows your case in detail and accordingly adjust doses. Another advice would be to seek support from family members and friends to tide over the grief of bereavement. It should be sufficient in most cases, but if that doesn't help seek psychotherapy as well which will aid recovery.  

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Dr. Saranya DevanathanPsychiatrist51yrs exp

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Dear Devika, Loss of family member is stressful for anyone. In under treated OCD, this kind of events may increase unwanted thoughts. Please consult your doctor frequently to increase the dose of serta for adequate response and add CBT with ERP, when necessary. With effective treatment, you will be able to deal with stresses in better way. 

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Dr. Suruchi Sonkar M.Phil. Phd.(Nimhans)Psychologist15yrs exp

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Dear Ms. lybrate-user, I understand you are going through a tough time, the grief of losing a family member can worsen anxiety associated with ocd. In addition to medications, grief therapy and exposure response prevention (erp, which is an evidenced based treatment for ocd can significantly alleviate the symptoms. My psychiatrist colleague suggests re-evaluating your present condition as there is scope for increase in your medications in proportion to severity and your response to medications. However, I would suggest you initiate therapy (grief counseling and supportive therapy for depression, followed by cbt) as well as to follow up your psychiatrist or week a re-evaluation for clarification regarding disage of medicine. Wish you a speedy recovery.  

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Dr. Prof Jagadeesan M SPsychiatrist18yrs exp

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It is not the first choice medicine for ocd, but does help in depression and also relives ocd symptoms in some patients. If it works well, in say about 2 to 4 weeks, consult your psychiatrist and continue the same. Else, it is wise to get a 2nd opinion. All the best.  

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Mr. Saul PereiraPsychologist51yrs exp

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yes, this is adequate but you are not combining therapy with the medication is of big concern. Your problem is created by your extreme fear. You must by now know the origin of this fear. Until you deal with this fear you are going to suffer the problems you have listed quite regularly. If you are against the use of medication, then you will have to work very hard with a counselor for a long time to recover. In fact the counselor may advice medication and will send you to a doctor. If you do not cooperate then it is futile and is a gross waste of time, money and opportunity. There is nothing wrong with use of medication since it is used as an addendum to the process of therapy. When the medication has served its purpose, then you can discontinue it on the advice of the doctor. In fact, you can mention this to him/her that you do not wish to be on medication for too long. S/he will tell you how long it will take and how much of your cooperation is required. All disorders have a chemical imbalance and that can ideally be stabilized by introducing medication, which are made to mimic the natural neurotransmitters the brain produces. When the chemistry is normalized there is no need for further medication. Then the doctor will gently and gradually withdraw the medication to tease the brain to produce the new normal. Remember you will need to work with the counselor even if you take medication. 

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