OCD and residual anxiety

病患者男 - 23歲

Dear psychiatrists,

I am 23 years old. I have OCD, anxiety and depression and I'm taking the following medications. However my OCD and anxiety are still dysfunctional. I have tried nearly all SSRIs and SNRIs and fluoxetine seems to work best. I also need to take two antipsychotic because taking one only does not help stabilize my mood. I need to take two benzos to reduce my anxiety effectively. I originally took valproate for mood stabilization, but it increased by ALT level so my psychiatrist switched me to lithium. I also know that the dosage of phenergan is high, but I can't sleep well without such a high dose.

1. Fluoxetine 80mg daily
2. Mirtazapine 45mg at bedtime
3. Aripiprazole 25mg daily
4. Olanzapine 15mg nocte
5. Clonazepam 0.5mg tds prn
6. Lorazepam 0.5mg tds prn
7. Pregabalin 250mg om and 250mg nocte
8. Valproate sodium CR 200mg nocte
9. Promethazine 100mg nocte prn
10. Lithium carbonate CR 400mg nocte

Despite being put on so many medications, my OCD and residual anxiety still make me dysfunctional. I am a university student and I am under academic deferment. I have unwanted thoughts of killing myself, such as jumping in front of an oncoming train or from a high place. Recently I developed symptoms of somatic OCD. I can't stop noticing my own breath. I regularly see my psychiatrist, clinical psychologist, counselor and social worker. My psychiatrist said she wouldn't make changes in my medications. What can be done to bring my OCD and residual anxiety under control?

簡重盛醫生回覆:
3/27/2022

Dear Sam

關於你的治療問題，你可以諮詢大學精神科學系的教授們(如你是在香港大學或中文大學就讀)，又或約見香港大學或中文大學精神科學系的教授們尋求治療(作為私家病人),祝安康。

簡重盛醫生

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