Obsessive-compulsive disorder treatment

Symptoms of obsessive-compulsive disorder can be caused by various reasons, so there is no specific treatment. If mental illnesses are diagnosed, they should be treated first, and in this case, drug therapy is indispensable. Psychotropic drugs can also be prescribed for obsessive-compulsive disorder; drug therapy is considered the most effective and reliable. Such drugs can only be used under the supervision of a doctor; the disease is chronic in most patients, and therefore exacerbations are possible. It is important to remember that you cannot use psychotropic drugs on your own. Even if a drug was very effective in the past, it may not help during the next exacerbation. Each episode of relapse requires a visit to a doctor and individual treatment.

Drug treatment

The drug of choice in the treatment of obsessions are antidepressants, which are capable of selectively inhibiting the process of serotonin reuptake. Preference is given to the drugs Fluvoxamine, Fluoxetine, Sertraline, Paroxetine. The drug is selected depending on the patient's tolerance, the severity of the obsessions, the need to use other drugs simultaneously, and concomitant diseases.

Fluoxetine is the most well-known and widely used of the above-mentioned drugs; it is not fast-acting and is excreted from the body for a long time (about three days), which contributes to the prolongation of the effect and rare cases of withdrawal symptoms. It inhibits the activity of liver enzymes, as do all the others, and often causes side effects from the nervous system - agitation, skin allergic reactions. It does not have a sedative or cardiotoxic effect. Depending on the severity of obsessions, one to three tablets of 20 mg per day are prescribed. If the patient takes the drug once, it should be taken in the morning. Contraindicated in decompensated epileptic paroxysms and severe liver dysfunction.

Fluvoxamine is the most powerful of the drugs, so in high doses it is more difficult to tolerate than others. Most often, side effects associated with digestive disorders are noted, and they are quite pronounced. When taking this drug, it is advisable to avoid drinking coffee and other products containing caffeine. This drug is taken starting with 50 mg per day, gradually increasing the dose to a therapeutically effective one (100-300 mg per day).

Paroxetine - of all drugs, has the highest probability of sedative action, long-term courses of treatment can lead to excess weight, rarely causes withdrawal syndrome. This drug is preferable if the patient complains of panic attacks. Contraindicated in patients with liver and kidney dysfunction. Can cause withdrawal syndrome, so stop taking it gradually. Start taking 20 mg per day, gradually (once a week by 10 mg) bringing it to the minimum effective dose (40-50 mg per day).

Sertraline - compared to the listed drugs, it has virtually no effect on transaminase activity and is generally considered the safest of them. This drug does not lead to weight gain even with long-term treatment.

All drugs are not used simultaneously with monoamine oxidase inhibitors, have many side effects, the most harmless of which are nausea and vomiting. They can change the composition of the blood, cause effects indistinguishable from the underlying disease, seizures and hypomania.

All drugs affect concentration, can cause sexual dysfunction (least - Fluvoxamine), attempts and thoughts of self-harm and are incompatible with alcohol. They are not prescribed to patients sensitized to them. Diabetics require dose adjustment.

In the treatment of obsessions, other psychotropic drugs can also be used - benzodiazepines (prescribed to patients with severe anxiety), neuroleptics (for severe compulsions), normothymics (enhancing the effects of SSRIs), and in the case of severe autonomic dysfunctions, β-blockers are prescribed to correct them.

When prescribing psychotropic drugs, the doctor focuses on the minimum effective duration of therapy.

Medication is necessarily combined with psychotherapy, which is based on teaching the patient to control obsessive states. Causal psychotherapy is used, which allows identifying the cause-and-effect relationship of obsessions, distinguishing elementary natural fears from imaginary ones, and reducing anxious reactivity.

Under the guidance of a psychotherapist, the patient will be able to study a number of methods that allow reducing nervous system tension and independently cope with obsessions, since obsessive states will periodically arise and it will often be necessary to resist their influence without the help of doctors and pills. Psychoanalysis, hypnosis are used, the patient is taught to master the basics of auto-training, other cognitive-behavioral techniques.

Feedback from forum members who have had obsessions suggests that many overcome this condition on their own and quite successfully. Trying to help their fellow sufferers, they tell how to fight obsessions.

The main techniques are considered to be the acquisition of skills:

• shift the emphasis from obsessive thoughts to productive ones, for which these obsessive thoughts must be recognized and driven away from oneself, without attaching any importance to them;
• reduce the significance of obsessive thoughts, realizing that they are not objective and have no basis;
• switch attention from obsessive ideas to objective thoughts and reasonable actions;
• gradually reduce the time spent on performing compulsive rituals, do not involve loved ones in their implementation.

The patient must realize that he is not healthy and that he must fight for his mental health. No one else will do this, so the responsibility falls entirely on him.

Meditation practices, breathing exercises, and yoga can have a good effect.

It is recommended to evaluate current events from a positive point of view, learn not to worry about trifles and avoid situations that cause obsessive thoughts.

Instead of medications, you can use herbal antidepressants - St. John's wort, hops, lemon balm, valerian, make infusions, drink teas with them. A practicing herbalist can help you choose the right products and prescribe a treatment plan. Pharmaceutical preparations based on herbal herbs - Persen, Novo-Passit, Gelarium hypericum, herbal infusions can be an alternative to synthetic antidepressants in cases of mild to moderate severity.

Physiotherapeutic treatment – medicinal electrophoresis, electrosleep, exposure to low-frequency pulsed intermittent currents, diadynamics have recently been increasingly used for neurological disorders.

Homeopathy

Homeopathy can usually give good results even in cases where official medicine is powerless. This branch of medicine has a wide arsenal of means for treating mental disorders, however, in order for the treatment to be effective, the drug must be prescribed by a psychiatrist with experience in working with homeopathic drugs or a homeopathic doctor.

In addition, there are homeopathic preparations produced by the pharmaceutical industry. They are devoid of individuality, but dilutions in small doses of active substances do not cause harmful side effects. These preparations have a mild effect and can be combined with drugs, help to relieve the side effects of psychotropic drugs, help reduce their doses, frequency and severity of obsessive paroxysms.

You can reduce central nervous system agitation, anxiety, worry, irritation or depression, and relieve vegetative symptoms with the help of Valerian-Heel drops. This drug is intended for course use. The drops contain eight components, including:

• Valerian (Valeriana officinalis) – used for anxiety disorders, neurasthenia and increased excitability, if the patient feels as if he is in a dream, seems to be a different person, for panic attacks, headaches, nervous tics;
• St. John's wort (Hyperiсum perforatum) is the main homeopathic antidepressant;
• Ammonium bromide (Ammonium bromatum) is a remedy for meticulous, pedantic, idealistic neurasthenics, an antidepressant, eliminates somatic manifestations;
• Potassium bromide (Kalium bromatum) – fear of mental disorder, paresthesia, anxiety, overexcitement;
• Sodium bromide (Natrium bromatum) – used for asthenia;
• Picric acid (Acidum picrinicum) – relieves the effects of mental and nervous fatigue;
• Common hops (Humulus lupulus) – used for clouded consciousness with preserved mental functions;
• Melissa officinalis – neuroses and neurasthenia, as an immunostimulant;
• Oats (Avena sativa) – nootropic action;
• Hawthorn (Crataegus) – improves blood circulation in the cerebral vessels, soothes;
• Chamomile (Chamomilla reсutita) – sedative effect.

Prescribed to children from the age of two, five drops diluted in 100 ml of water, upon reaching the age of six, ten drops are dripped into water per dose, from the age of twelve - an adult dose of 15 drops, at night it can be increased to 20 drops. The frequency of administration is three times a day, half an hour after it you can eat. If desired, you can take the required dose 60 minutes after eating.

To improve cerebral circulation, normalize metabolic processes, slow down mental and intellectual degradation, such a drug as Cerebrum compositum will help. This is a whole homeopathic composition, including 26 components of different origin, among which:

• the intestinal substance of the sperm whale Ambra grisea, Aconite (Aconitum), the gonorrheal nosode Medorrhinum-Nosode, used in homeopathic practice as monopreparations for the treatment of phobias;
• St. Ignatius beans (Ignatia) are a constitutional remedy for psychasthenics, a symptomatic remedy for a wide range of nervous and mental disorders caused by both ordinary troubles and severe mental trauma;
• Thuja (Thuja) is a constitutional remedy for anxious, suspicious patients, overcome by obsessive ideas;
• Black henbane (Hyoscyamus niger) – religious, sexual, contrast obsessions, compulsions.

The drug contains other substances that help restore and normalize brain functions.

The drug is injectable, used intramuscularly, subcutaneously and intradermally, and if necessary, intravenously. Injections are given one to three times a week. A single dose for patients aged six and over is a whole ampoule, for children aged 1-2 years the ampoule is divided into four to six parts, for children aged 3-5 years – into two or three parts.

You can use the solution for oral administration by diluting the contents of the ampoule in a quarter glass of clean water. The portion should be drunk during the day, divided into equal parts and held in the mouth before swallowing.

Nervo-heel tablets can help to be prescribed to a patient with obsessive-compulsive disorder. The complex includes:

• Phosphoric acid (Acidum phosphoricum), Scabies nosode (Psorinum-Nosode), St. Ignatius beans (Ignatia), substance from the ink bag of cuttlefish (Sepia officinalis) are homeopathic antidepressants, also used in the treatment of obsessive-phobic disorders, emotional shocks, schizophrenia, epilepsy and other mental pathologies;
• Potassium bromide (Kalium bromatum) – fear of mental disorder, anxiety, overexcitement, convulsions;
• Valerian-zinc salt (Zincum isovalerianicum) – insomnia, convulsions, other manifestations of dysfunction of the nervous system.

From the age of three, use sublingually, one whole tablet, the scheme for stopping acute conditions: take a single dose at fifteen-minute intervals, but no more than eight times in a row, then every eight hours half an hour before meals or an hour after. For children under three years old, the tablet is divided in half for one dose.

To eliminate the effects of drug intoxication and relieve side effects after treatment with psychotropic drugs, as well as to strengthen the immune system and nervous system, restore hematopoiesis, normalize metabolic processes in the cells of the brain, hematopoietic and excretory organs, homeopathic oral drops Psorihel N and Lymphomyosot, injectable multicomponent drugs Ubiquinone compositum and Coenzyme compositum are prescribed.