Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Intermittent Depression And Health Anxiety OCD
Question: Hi,
I am a 56 year old woman who has been diagnosed with health anxiety OCD, gad and on and off depression. I am currently on 30 mg. remeron, doing a Valium taper to get off Ativan. I've been on and off so many meds over 5 years and have a difficult time with most, especially the ssri's, since menopause. My doctor has suggested adding 300 mg. of lithium to help with the anxiety and depression or pristiq which I'm nervous about the discontinuation problems. I had a gene test which shows I have the double s allele and comt met/met gene. Was wondering if lithium is good for unipolar anxiety/depression or pristiq. The anxiety is pretty bad. Also seeing a cbt therapist. I've been on and off about 20 meds over the 5 years and don't know if this has created the anxiety or the Valium taper. Been doing it very slowly. Hate to start yet another drug but was told lithium is fairly benign and easy to come off of.
Thank you
I am a 56 year old woman who has been diagnosed with health anxiety OCD, gad and on and off depression. I am currently on 30 mg. remeron, doing a Valium taper to get off Ativan. I've been on and off so many meds over 5 years and have a difficult time with most, especially the ssri's, since menopause. My doctor has suggested adding 300 mg. of lithium to help with the anxiety and depression or pristiq which I'm nervous about the discontinuation problems. I had a gene test which shows I have the double s allele and comt met/met gene. Was wondering if lithium is good for unipolar anxiety/depression or pristiq. The anxiety is pretty bad. Also seeing a cbt therapist. I've been on and off about 20 meds over the 5 years and don't know if this has created the anxiety or the Valium taper. Been doing it very slowly. Hate to start yet another drug but was told lithium is fairly benign and easy to come off of.
Thank you
Brief Answer:
lithium works well in unipolar depression and anxiety.
Detailed Answer:
Hello
Welcome to HCM.
I have read your details and completely understand your concerns.
You have OCD, GAD and occasional depression. You have tried multiple medications and had tolerability issues with them.
Now your main concern is about lithium.
Lithium is a good drug in the sense that it works in almost all type of mood disorders, ranging from unipolar depression to bipolar disorders.
I think lithium should work for you. Lithium at 300mg is safe to start. It may cause gastric upset for initial few days.
Yes, pristiq has the probability of causing discontinuation symptoms which again would be a problem for you. It also has tolerability issues in some cases.
Going on and off multiple medications can be a cause for anxiety as well. I do not think its valium taper.
In my clinical experience, I have used amisulpride(prescription drug) for depression and anxiety to a good effect. You can discuss about this with your doctor.
I would also advise you to go for thyroid status and Blood vitamin B12 levels evaluation. Altered levels can be a cause for non-response to drugs.
Hope this helps.
Feel free to ask further.
Take care.
Thanks.
lithium works well in unipolar depression and anxiety.
Detailed Answer:
Hello
Welcome to HCM.
I have read your details and completely understand your concerns.
You have OCD, GAD and occasional depression. You have tried multiple medications and had tolerability issues with them.
Now your main concern is about lithium.
Lithium is a good drug in the sense that it works in almost all type of mood disorders, ranging from unipolar depression to bipolar disorders.
I think lithium should work for you. Lithium at 300mg is safe to start. It may cause gastric upset for initial few days.
Yes, pristiq has the probability of causing discontinuation symptoms which again would be a problem for you. It also has tolerability issues in some cases.
Going on and off multiple medications can be a cause for anxiety as well. I do not think its valium taper.
In my clinical experience, I have used amisulpride(prescription drug) for depression and anxiety to a good effect. You can discuss about this with your doctor.
I would also advise you to go for thyroid status and Blood vitamin B12 levels evaluation. Altered levels can be a cause for non-response to drugs.
Hope this helps.
Feel free to ask further.
Take care.
Thanks.
Above answer was peer-reviewed by :
Dr. Prasad
Hi,
Thank you for answering so quickly. My b12 levels were normal. Had a thyroid scan which showed a small 3 mm solid
Nodule with slight bilateral swelling but my thyroid levels were within normal range. Had a tsh, free t3 and free t4. Thyroid antibodies of 28 and thyroid globulin of 1.8. Saw a very well respected endocrinologist who said this was normal to have and not Hashimoto's since my levels were within normal range and I didn't have hypothyroid symptoms. The nodule will be monitored and ultrasound redone in a year. Wish it was that simple to take thyroxine or synthroid. Saw an immunologist/allergist prior to him who thought it might be Hashimoto's due to the presence of thyroid p antibodies. Due to health anxiety, I'm trying to believe the endocrinologist I saw.
Thank you for answering so quickly. My b12 levels were normal. Had a thyroid scan which showed a small 3 mm solid
Nodule with slight bilateral swelling but my thyroid levels were within normal range. Had a tsh, free t3 and free t4. Thyroid antibodies of 28 and thyroid globulin of 1.8. Saw a very well respected endocrinologist who said this was normal to have and not Hashimoto's since my levels were within normal range and I didn't have hypothyroid symptoms. The nodule will be monitored and ultrasound redone in a year. Wish it was that simple to take thyroxine or synthroid. Saw an immunologist/allergist prior to him who thought it might be Hashimoto's due to the presence of thyroid p antibodies. Due to health anxiety, I'm trying to believe the endocrinologist I saw.
Brief Answer:
lithium can precipitate thyroid disorders.
Detailed Answer:
You are most welcome.
I should also say that you believe your endocrinologist.
Since there is some doubt about your thyroid status, the use of lithium has to be cautious. Lithium can precipitate thyroid disorders.
So, in that case, pristiq would be a better choice. Starting with low dose of 25mg can help you to tolerate the easily.
Keep the regular follow-up with your doctor for thyroid status.
I would advise you to practice relaxation exercises like deep breathing and meditation. This should also help you a great deal.
I wish you well.
Take care.
Thanks.
lithium can precipitate thyroid disorders.
Detailed Answer:
You are most welcome.
I should also say that you believe your endocrinologist.
Since there is some doubt about your thyroid status, the use of lithium has to be cautious. Lithium can precipitate thyroid disorders.
So, in that case, pristiq would be a better choice. Starting with low dose of 25mg can help you to tolerate the easily.
Keep the regular follow-up with your doctor for thyroid status.
I would advise you to practice relaxation exercises like deep breathing and meditation. This should also help you a great deal.
I wish you well.
Take care.
Thanks.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thank you very much. Will consider both options.
Take care
Take care
Brief Answer:
happy to help.
Detailed Answer:
You are most welcome.
Kindly close the discussion if you have no more queries and give your valuable feedback.
Take care.
Thanks.
happy to help.
Detailed Answer:
You are most welcome.
Kindly close the discussion if you have no more queries and give your valuable feedback.
Take care.
Thanks.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
