Side effects of medications for obsessive-compulsive disorder (OCD)?
Dr.
Liang: I apologize for the lengthy message, and I really appreciate your patience in reading and responding! I am a repeat examinee with obsessive-compulsive disorder, and I take one tablet of Sertraline (Zoloft) daily.
After starting the medication, I have noticed some changes.
Before taking the medication: 1.
When classmates would chat with me, I would think, "Everyone else is studying; can we not chat? This is such a waste of time." 2.
In class, I would force myself to maintain a serious demeanor, and if I didn't, I would feel guilty.
After taking the medication: 1.
When classmates chat with me for a long time, I no longer feel unhappy or bothered.
2.
I still attend class, but I don't feel that intense drive; I can daydream without feeling guilty.
I'm not sure if these changes are related to the medication (I think they are), and I don't know if these changes are good or bad.
My anxiety about studying has increased due to my decreased motivation, and I often think about stopping the medication, but I'm hesitant because my symptoms have improved significantly with it.
I also wonder if this reaction after starting the medication is actually normal? My mind feels so chaotic.
Could you please give me some advice? Should I consider reducing my dosage? Is there a way to determine if my dosage is too high? My doctor has advised me to adjust the dosage based on side effects, with a maximum of one tablet, but I find it difficult to judge how much I should take.
Z, 10~19 year old female. Ask Date: 2021/12/21
Dr. Liang Sunyuan reply Psychiatry
Hello Z: In terms of the treatment dosage for obsessive-compulsive disorder, taking one tablet of fluoxetine (Prozac) per day is considered a low dose and should not cause significant side effects.
It is recommended to maintain the current dosage and to increase your motivation through self-reminders.
If you still have concerns, it is advisable to discuss them with your physician during your next appointment.
Wishing you all the best.
Reply Date: 2021/12/21
More Info
Understanding the side effects of medications, particularly for conditions like Obsessive-Compulsive Disorder (OCD), is crucial for managing both the disorder and the impact of the medication on daily life, including study habits. In your case, it seems that you are experiencing some changes in your behavior and emotional responses since starting the medication, which is a common occurrence.
Firstly, it’s important to recognize that medications like escitalopram (the active ingredient in "憂必晴") are selective serotonin reuptake inhibitors (SSRIs). These medications are often prescribed for OCD and can help alleviate symptoms by increasing serotonin levels in the brain, which can improve mood and reduce anxiety. However, they can also lead to side effects that may affect your cognitive functions and emotional responses.
From your description, it appears that before taking the medication, you had a heightened sense of responsibility regarding your studies, which translated into feelings of guilt when you engaged in activities that you perceived as distractions. After starting the medication, you noted a decrease in this guilt and a more relaxed attitude towards social interactions and classroom engagement. While this may seem like a positive change, it can also lead to concerns about decreased motivation and productivity, especially for someone preparing for exams.
The changes you are experiencing could be attributed to the medication's effects on your anxiety levels and cognitive processing. SSRIs can sometimes lead to a blunting of emotions, which might explain why you feel less guilty about not being as focused in class or studying. This emotional dampening can be beneficial in reducing anxiety but may also result in a lack of drive or motivation, which is understandably concerning for a student.
Regarding your question about whether to reduce your medication dosage, it’s essential to approach this carefully. Since your doctor has advised you to adjust your dosage based on side effects, you might consider keeping a journal to track your feelings, study habits, and any side effects you experience. This can help you and your doctor make informed decisions about your treatment plan. If you notice that the changes in your motivation are significantly impacting your ability to study or perform academically, it might be worth discussing these observations with your doctor.
Additionally, it’s important to consider that the effects of SSRIs can vary significantly from person to person. Some individuals may find that they need to adjust their dosage to find a balance between managing their OCD symptoms and maintaining their motivation and cognitive function. If you feel that your current dosage is too high, or if you’re experiencing side effects that are concerning, it’s crucial to communicate this with your healthcare provider. They can help you assess whether a dosage adjustment is appropriate or if other interventions might be beneficial.
In conclusion, while the medication may be helping to alleviate some of your OCD symptoms, it’s also impacting your study habits and emotional responses. Keeping track of these changes and discussing them with your doctor will be key in finding the right balance in your treatment. Remember, managing OCD is a process, and it’s important to find a treatment plan that supports both your mental health and your academic goals.
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