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How To Treat Ocd When Comorbid With Bipolar?

bipolar ocd

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#1 Larkspur


    Amateur Psychopharmacologist

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Posted 17 February 2012 - 11:13 AM

Hi folks,

I have bipolar II and OCD (amongst other things). My OCD symptoms (compulsive hoarding/collecting, intrusive thoughts of injury, etc.) are totally out of whack since I went off Celexa. Celexa was great for my OCD, I had everything on lockdown, but then I had a hypomanic episode induced by Remeron....so now I'm only taking Seroquel and Depakote. The Depakote is short-term and will be switched to Lamictal at my next appointment.

Now, I know that once I am all the way up around 300mg of the Seroquel that it will start having serotonergic effects. I saw online also that there were promising studies about Lamictal helping with OCD. But by far, the best evidence seems to be for SSRI's or tricyclics.

Is there anyone else out there who is bipolar II and also OCD? I think I really want to try Prozac once I'm all levelled out, or maybe back to Celexa, but my pdoc is adamant right now that I can't take antidepressants until stable, and even then maybe not ever. I don't think I will be able to live a useful, fruitful life with my current levels of OCD/anxiety. I'm usually pretty lethargic, and I heard Prozac can be very activating and anoretic. I'm morbidly obese and also have ADHD so any "side effects" that would help with that would be great.

I feel like OCD is ruining my life. I have no motivation to walk my dogs, to clean my house, to work...but I am positively DRIVEN to expand my collection of nail polish, close all the blinds in the house and re-check to make sure they stay closed, etc.It's unpleasant, and fiscally unhealthy since I don't need to be spending my whole tax refund on nail art!!

Any other comorbid OCD/bipolars in the house? How do you and your doc treat it?
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Current Dx: bipolar ii, predominantly depressed/mixed; obsessive-compulsive disorder; generalized anxiety disorder and social phobia; attention deficit

Current situation: Wellbutrin XL 450mg, Prozac 80mg, lithium 300mg x2, Stelazine 1mg x3, Adderall 15mg x2 

P.R.N. Zyprexa 5-10mg for mixed episodes, Ativan 0.5mg for anxiety

Physical malady meds:  Mirena IUD, levothyroxine 50mcg, spironolactone 50mg x2

OTC/supplements: women's multivitamin & fish oil daily, 50,000 IU Vitamin D weekly


Rx Graveyard: Saphris (asenapine), Brintellix (vortioxetine), Latuda (lurasidone), Lexapro (escitalopram), Depakote (sodium valproate), Sonata (zaleplon), Valium (diazepam), Catapres (clonidine), Restoril (temazepam), Xanax (alprazolam), Tegretol (carbamazepine), Pamelor (nortriptyline), Zyprexa (olanzapine), Viibryd (vilazodone), Topamax (topiramate), Thorazine (chlorpromazine), Luvox (fluvoxamine), Vistaril (hydroxyzine), Geodon (ziprasidone), Lamictal (lamotrigine), Seroquel XR (quetiapine), dextroamphetamine, Nuvigil (armodafinil), Ritalin (methylphenidate), Abilify (aripiprazole), Remeron (mirtazapine), Celexa (citalopram), Ambien/Intermezzo (zolpidem), Effexor XR (venlafaxine), Desyrel (trazodone), Lunesta (eszopiclone)

#2 curry


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  • Current Meds:Lamictal, Zoloft, Ambien

Posted 10 March 2012 - 05:06 PM

Hi Larkspur, I too have OCD and bipolar2.

I was first dx in 1994 with OCD and depression, and I took Anafranil and Prozac with HUGE success for 8 years. then I could not tolerate Anafranil anymore due to side effects and the crazymeds journey began.

I had Some relief with Effexor but never could get the clear mind like I had with Anafranil. In 2005 my pdoc decided I was bipolar2 and I tried nearly all the mood stabilizers, but still no relief so went back to effexor. Am starting over again now after a year from mood/depression hell. Taking lamictal ( super slow titrate as I had rash before) and pdoc insisted on 100mg Zoloft as I was so depressed. Zoloft did help depression but has made me extremely anxious, agitated and irritable so I just starting cutting back on it.

I am hoping for the best with lamictal but it will be a long time to get to a decent dose (titrating up 12.5 every 2 weeks; currently at 37.5mg).
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#3 metatrix


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Posted 11 March 2012 - 09:32 AM

I have OCD, Trichotillomania/hair-pulling (which some people consider a part of the OCD spectrum, although it's more of an 'impulse control' disorder), and Bipolar I. I have tried various SSRIs/SNRIs for my OCD and Trich, none have worked. The atypical antipsychotics (especially abilify) works extremely well for my Trichotillomnia. BUT, it doesn't work for the rest of my OCD. This makes me think that OCD and Trich (at least in me) have different biological etiologies/work on different NT systems.

I have been on SSRIs, SNRIs, stimulants, and atypical antipsychotics...NOTHING has worked for my OCD. Honestly, I've sort of given up. I've tried CBT and hypnosis as well, and it didn't work either. I'm on Depakote now....we'll see if that does anything for my OCD, but I'm not holding my breath.

OCD can be really difficult to treat. *hugs*
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Age: 23; Dx: Bipolar I, ADHD, OCD, Trichotillomania, Tourette's Syndrome, GAD, Social Phobia, Borderline Personality Disorder, Restless Legs Sydrome; Current Meds: Dexamphetamine (Dexedrine SR) 35 mg, Duloxetine (Cymbalta) 60 mg, Aripiprazole (Abilify) 4 mg, Divalproex sodium (Epi-Val/Depakote) 1000 mg; Lorazepam (Ativan) 1 mg prn; Iron Supplements Past Meds: Paroxetine (Paxil), Citalopram (Celexa), Sertraline (Zoloft), Risperidone (Risperdal), Ziprasidone (Zeldox), Amphetamine (Adderall XR), Methylphenidate (Ritalin).

#4 sbrown1991


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Posted 14 July 2013 - 09:45 PM

I have bipolar 1 and OCD. I take lamictal, viibryd which is a new ssri, and latuda which is a newer antipsychotic. Being on lamictal is great for my bipolar because I don't have any mixed episodes anymore which were terrible because I would rage, become psychotic, cry, be depressed, have suicidal thoughts and sometimes cut myself. Since you guys are bipolar 2 you probably haven't had a mixed episode but there hell compared to depression. I've only had straight mania once for 2 days and then I started drinking a lot of alcohol and it turned into a mixed episode fast. a mood stabilizer and an antipsychotic are the way to go for bipolar disorder. you may not even have to be on an antipsychotic. I only am because I hear voices, have paranoia, and sometimes have delusions. Now for my OCD I started having symptoms before my bipolar even came out. I didn't get diagnosed with ocd until 6 months after bipolar but I could tell what my ocd symptoms were for 3 years without even knowing I had ocd. Now when I had mood episodes my ocd was almost masked so it wasn't even a problem for 5 months. its like it went away because my mood problems were so severe. When I got my bipolar under control my OCD started up back in full effect. I have HOCD and other sexual obsessions like incest and sometimes pedophilia. I get extreme anxiety over this and it sometimes haunts me in my dreams. being on an ssri helps but I need CBT eventually.

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