Wellbutrin vs zoloft for ocd

I was diagnosed with OCD when I was 8 12 years ago and have been pretty consistently on Zoloft with varying doses. Recently, I was given a perscription for Wellbutrin to accompany my Zoloft. I am currently taking mg Zoloft and mg Wellbutrin.

for wellbutrin vs ocd zoloft

See related handout on excessive worrywritten by the authors of this article. Worry is a normal response to uncertainty. Education, empathetic support, reassurance, and passage of time usually ameliorate ordinary worries. However, these common-sense strategies for dealing with transient worries often prove ineffective for patients with excessive worry, many of whom meet the criteria for disorders in the Diagnostic and Statistical Manual of Mental Disorders4th ed.

Evidence-based treatments for such disorders can assist family physicians in management of persistent worry as a self-perpetuating habit across zoloft for ocd categories. Antidepressants and cognitive behavioral therapy are effective treatments for various what can you not take while on accutane characterized by excessive worry. Cognitive behavioral strategies that may be adapted to primary care contacts include education about the worry process, repeated challenge of cognitive distortions and beliefs that underpin worry, behavioral exposure assignments e.

Worry is an effective short-term response to uncertainty that can become self-perpetuating with adverse long-term consequences. Worry reduces subjective uncertainty, contributes to a sense of vigilance and preparedness, dampens autonomic arousal, and fuels the belief that uncertain events and overall risk can be controlled. Worry also is a form of emotional suppression and cognitive avoidance that becomes self-perpetuating, in part because it blocks other emotions such as fear or anger.

The patient with excessive worry wellbutrin displays a constellation of maladaptive beliefs and habits involving worry Table 1. Antidepressants in particular, escitalopram [Lexapro], paroxetine [Paxil], sertraline [Zoloft] and venlafaxine [Effexor] are effective treatments for serious worry-prone disorders e. Psychological treatments, especially cognitive behavioral therapy tailored to the specific diagnosis, are effective for worry-prone disorders e.

Selective serotonin reuptake inhibitors can be considered for treatment of hypochondriasis, although for ocd from controlled trials is lacking. For information about the SORT evidence rating system, see page or https: For ocd it feels dangerous, it is dangerous. It keeps me from being blindsided. It keeps loved ones safer. I am making myself sick. I have got to stop worrying. Many patients with zoloft for ocd worry overvalue, but comparison between valium and xanax fear, their propensity to worry, often with concern that so much worry will harm their "zoloft for ocd." Although they intentionally indulge in worry at times, their distress about worrying prompts repetitive, unsuccessful efforts to control it.

These efforts to suppress intrusive thoughts are usually ineffective and paradoxically may magnify worry and anxiety. The environmental, neuroanatomic, neurophysiologic, and genetic components of excessive worry are still being defined. The various clinical presentations of worry may reflect the relative activation or availability of these structures and neuro-transmitters, although the issue of cause versus consequence has not been resolved.

Patients are unlikely to complain of excessive worry unless asked. They may present with another problem e. Persistent worry most commonly is zoloft for ocd in patients with certain disorders and similar subthreshold presentations Table 2. Comorbidity and overlap among categories often make it difficult to distinguish among disorders, especially given individual variations over time.

Some patients adipex keep weight off a single disorder and some will meet criteria for multiple diagnoses, whereas others present with various symptoms or diagnoses over a period of years, all with a common theme of excessive worry. For ocd figures suggest that generalized anxiety disorder and hypochondriasis, plus subthreshold variations of these disorders, most often characterize patients with excessive worry who are encountered in primary care.

Generalized anxiety disorder Nearly daily, marked worry with variable content. Some patients overuse physicians, medical textbooks, Web sites, or self-checking for reassurance; some patients underuse physicians to avoid potential bad news. Content of worry often focuses on guilt, self-reproach, and self-perceived incompetence or badness. Self-critical worry about the past; helpless worry about the present; pessimistic worry about the future. Compulsive reassurance-seeking, checking, or sanitizing may momentarily relieve anxiety at the cost of perpetuating the soma vs flexeril recreational. Generalized anxiety disorder GAD was once a default category for anxious patients who did not meet the criteria for another more specific anxiety disorder.

The lifetime prevalence of GAD in the general population is approximately 5 percent; however, for ocd is an 8 percent cross-sectional prevalence rate among primary care patients, indicating that this is the anxiety disorder most often seen by family physicians. In one sample, 87 percent of primary care patients with GAD did not present for ocd a primary symptom of anxiety; most had non-specific somatic complaints e. As soon as I finish one task, I start to worry about everything else I have to do.

When there is nothing more I can do about a concern, Does xanax prevent anxiety attacks ocd zoloft for not worry about it ocd more. Reverse score items 1, 3, 8, 10, and 11, then sum all 16 items. Possible scores range from 16 to Means for groups with generalized anxiety disorder range from 60 to Development and validation of the Penn State Worry Questionnaire.

Behav Res Ther ; Escitalopram Lexaproparoxetine Paxilsertraline Zoloftand venlafaxine Effexor are indicated by the U. According to a Cochrane Database review, 9 imipramine Tofranilparoxetine, and venlafaxine are the best-evaluated antidepressants that are effective for GAD. Relaxation training can dampen muscle tension and bodily arousal and has demonstrated effectiveness comparable with cognitive treatment for GAD in some studies. Recent controlled trials 11 of worry-focused cognitive behavioral therapy CBT have demonstrated effectiveness for GAD.

Although preliminary outcome data are encouraging, adequate trials are still pending. Hypochondriasis is characterized by a persistently distressing preoccupation with fears or for ocd that one has a serious illness. Such worries often prompt the seeking of excessive reassurance from physicians, medical textbooks, and Web sites, or repeated ocd and symptom monitoring.

Patients selectively attend to benign bodily sensations and to health information that confirms their suspicion while ignoring disconfirming evidence. Little is known about the pharmacologic treatment of primary hypochondriasis. Small, open trials of paroxetine "wellbutrin" and fluvoxamine Luvox 18 suggest that many patients with marked health anxiety may benefit. Evidence is accumulating that the "for ocd" cluster of somatoform disorders e.

In a study of patients with hypochondriasis, psychological treatment rather than medication was perceived to be first-line treatment by 74 percent of patients and as the only acceptable treatment by 48 percent ocd patients. The CBT package specifically targeted amplification of benign symptoms, faulty symptom attributions, errant beliefs about health and disease, maladaptive illness behaviors, and selective attention strategies. The effectiveness of this treatment for patients with hypochondriasis corroborated the results of earlier RCTs.

Diagnosis-tailored, cognitive behavioral treatments have demonstrated effectiveness for panic disorder, 24 social phobia social anxiety25 1.5 mg klonopin first time stress disorder, 26 obsessive-compulsive disorder, 27 and depression. The effectiveness of SSRIs and venlafaxine in controlled trials of treatment for the psychiatric disorders most often linked with excessive worry "ocd" that these medications should be first-line pharmacologic treatments.

The effectiveness of CBT for these disorders suggests that such techniques will be adapted successfully to treat excessive worry across diagnostic categories and wellbutrin zoloft subthreshold presentations Table 4 9 — 1317 — 1921 — There is limited evidence that psychosocial treatments for these disorders can be adapted effectively for use by family physicians in brief contacts.

These patients may benefit from zoloft for ocd, intermittent counseling focusing on: CBT 10 — SSRIs 17 — CBT 28 Interpersonal psychotherapy FDA-indicated medications for zyprexa im and ativan im contraindication disorder are listed second.

Information from references 9 through 1317 through 19and 21 through Although family physicians usually are not formally trained in CBT, the concepts and techniques can be adapted to brief primary care counseling and supplemented with readings and behavioral assignments. Table 5 summarizes potential teaching points can i donate blood on lexapro practical strategies derived from CBT for use in brief, zoloft for ocd care education and counseling of the patient with excessive worry.

These points can be chosen lexapro making me angry adapted for adults with various educational levels or for children. Any brief primary care contact may focus on a single counseling point, worry-management strategy, or assignment. Worry rarely saves us from anything. Most things we worry about are unlikely events. The bad what does adderall looks like that happen to us are rarely anticipated through worry and rarely allow us any control.

A compelling worry is still just a thought that will pass. Challenge your distorted risk assessments: Remind yourself about the transient nature of worries: Frequently "for zoloft" reassurance e. The brief relief provided by reassurance only perpetuates the worry cycle. If you repeatedly seek reassurance from your physician or spouse, encourage them to gradually withhold the reassurance that only perpetuates the problem. It is simple, but not easy. Learning to be in the wellbutrin, focusing on your breathing and accepting the contents of your thoughts, can gradually ameliorate worry as you become more skilled.

What we resist persists. We think about what we are striving not to think about. Do not try to eliminate your worries. Worried thoughts can be accepted as background noise without being actively engaged. This only perpetuates the worry cycle. Maximize your distress without reassurance. When worries intrude at other times, try to defer them until your next scheduled worry period, perhaps using a written list. More worrying will not yield control or certainty.

If a worried thought is truly a signal, it should dictate certain actions. If a worry does not call for action other than reassurance seekingit is likely to be merely noise, not a signal. Learn to challenge your futile quest for certainty and control. Notice the many uncertainties and things you cannot control throughout the day, and practice mindful acceptance of each.

Remember, certainty is only a feeling, and rarely is a for ocd. When you give credence to your worried thoughts, your body will respond with tension, anxiety, and somatic symptoms.

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