Sir. Having ocd. Taking prodep 60 for around 10 yrs. Things were ok. But recently last year symptoms started increasing. After doctor consult, started with clofranil 50 from 25 at night. After a time again it was fine. Stopped clofranil slowly after doctor consult. 6 to 7 months things were under control. Recently had to start clofranil again for symptoms .please suggest the best way to treat this.

Mr. Saul PereiraPsychologist49yrs exp

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You badly need to combine medication with therapy. Meet with a counselor immediately. Please take your parents with you to determine the possible developmental issues that may have contributed to this condition. This is a fear-based condition and for some reason you have not been dealing with this childhood fear which has now developed unto these repetitive adaptations to seem to need it for normal functioning. The behavior will then become based on magical thinking and certain rituals will become necessary to do normal things making you believe that either the frequency or the ritual is important to its success. This of course is a fallacy but there will come a time that even if told the truth, your belief will defy any logic and you will continue behaving like that even if it cripples you in your daily routines. It only appears as though some other force is behind these behaviors and that you are compelled to act in this fashion. That is obviously not true but no one can convince you of anything different. The obsession is a repeating thought pattern with no meaningful outcome; and the compulsiveness is the need to act on those obsessions also in a repeated behavior pattern as though you just cannot help yourself. This is all driven by fear and when you are frustrated with it, you will escalate anger over it. Doubt, insecurity, uncertainty, and lack of firm memory will all plague you and increase stress. There are certain behavioral techniques to be implemented and if they work you may get out of this condition rather easily. Medication in combination with counseling will work better and give you a chance to improve to the point of stopping the medication in the long run, and with good cooperation much can be achieved.  

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Mrs. Aaradhana ReddyPsychologist3yrs exp

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Dear Lybrate user, the reappearing of the symptoms could itself be some stress, must be difficult. But, we need more information on this, because this could happen because of various reasons, it could be environmental or personal like some stressors etc. You could have faced. Maybe to understand this a combination of counselling and medicines could be of better help. This could help better in managing ocd. With regard to medication though, consult with your psychiatrist and explain to him your above concerns. If you need help you can reach out to me as well. All the best!  

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Dr. Saranya DevanathanPsychiatrist49yrs exp

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Dear Swarup Sen, You are already in the best hands for treatment of ocd. Ocd needs long term treatment. At times of relapses, you need extra tablets for few months. You can also try to add CBT with ERP during your normal days. 

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Dr. Prof. Jagadeesan M.S.Psychiatrist16yrs exp

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Ocd is a long term, for most life time disorder. You need to consult psychiatrist periodically for evaluation and treatment and monitor the side effects, resistance to the medications. For you after few years you likely had lack of response to prodep hence the psychiatrist has rightly changed to clofranil. If after tapering down symptoms recur, you need to consult again and take appropriate medications continuously. Good luck.  

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Dr. Karuna ChawlaHomeopathy Doctor24yrs exp

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Write down your obsessive thoughts or worries. Keep a pad and pencil on you, or type on a laptop, smartphone, or tablet. When you begin to obsess, write down all your thoughts or compulsions. Keep writing as the ocd urges continue, aiming to record exactly what you’re thinking, even if you’re repeating the same phrases or the same urges over and over. Writing it all down will help you see just how repetitive your obsessions are. Writing down the same phrase or urge hundreds of times will help it lose its power. Writing thoughts down is much harder work than simply thinking them, so your obsessive thoughts are likely to disappear sooner.  

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