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Mental & Emotional Health
Question #28730
27 days ago
85

Seeking Advice on OCD Treatment Options - #28730

Client_3fc49a

Dear Doctor, I have severe OCD, especially related to compulsions. Obsessions: I have very disturbing sexual obsessions—sexual thoughts and images, violent thoughts, concerns about symmetry and cleanliness. For example, sexual thoughts come to my mind and do not go away quickly. I also have sexual obsessions regarding people I interact with, especially schoolmates. Overall, sexual obsessions are the strongest for me. I have undergone psychotherapy, which has been very effective. After three months, my OCD symptoms have decreased significantly. However, sometimes, for example while studying or under academic pressure, the obsessions become stronger. When my academic workload is low, my obsessions are weaker. They also worsen when I am under social pressure. I also read a book that helped me a lot: “Unlocking the Obsessive Brain” from UCLA in New York. Compulsions: I have the compulsion to pull or pick (skin/hair), but my compulsions are much less severe compared to my obsessions. I am 17 years old. Based on my research from books and other sources, SSRIs seem suitable for me, especially Sertraline and Fluoxetine, but I am worried about their side effects and whether they could harm me. If possible, could you advise which medication would be most suitable for me? I have had OCD for approximately three years, as far as I can remember, but I cannot be sure about my childhood. In the last six months, my symptoms have become strong enough to affect my daily life. In conclusion, after three months of psychotherapy, about half of my OCD symptoms have improved, but sometimes they become strong again, and I feel I need medication.

How would you rate the severity of your OCD symptoms currently?:

- Severe, significantly impacts daily life

Have you previously tried any medications for your OCD?:

- No, I haven't tried any

How often do you experience these obsessions and compulsions?:

- Frequently, almost daily
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Doctors' responses

Dr. Shayeque Reza
I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.
26 days ago
5

You are a 17-year-old experiencing daily worsening of obsessive thoughts consistent with Obsessive compulsive disorder, and it is very positive that psychotherapy has already helped you significantly. However, since symptoms still persist and affect your daily life, adding medication can be beneficial, but this must be done under the supervision of a psychiatrist, especially at your age. The most commonly used and effective medications are Selective serotonin reuptake inhibitors such as fluoxetine, sertraline, or fluvoxamine, which help reduce obsessive thoughts and anxiety over time. These medicines require proper dosing, monitoring, and follow-up to avoid side effects and ensure safety. You should not start any medication on your own. In summary, your condition is treatable, therapy is already helping, and with proper psychiatric guidance, combining therapy with medication can further improve your symptoms and quality of life.

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Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
26 days ago
5

Hello dear See ocd is not a disease but is a combination of strict regular habits and anxiety. Iam suggesting some precautions for improvement Please follow them for atleast two months Do physical exercise atleast half an hour daily for 5 months Do meditation Take good balanced diet for good health Engage in social media Indulge in hobbies like reading and writing Avoid overthinking Avoid junk food and alcohol/ smoking Set your goals for every day Hopefully improvement will occur In case of no improvement in 2 month consult psychiatrist in person for better clarity Regards

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When considering medication for OCD, SSRIs like Sertraline and Fluoxetine are indeed commonly prescribed options. They are often effective in reducing the intensity of obsessions and compulsions. Both medications have a well-documented use in OCD treatment, though they can affect individuals differently. Side effects might include nausea, headache, sleep disturbances, or sexual dysfunction, but these often vary in intensity and occurrence from person to person. Typically, the benefits will outweigh potential side effects, and using them under the guidance of a healthcare professional helps ensure that any adverse effects are appropriately managed. It’s crucial that dosage and choice between Sertraline and Fluoxetine be personalized based on your medical history, potential interactions with other medications or conditions, and specific symptom profile.

Since you’re 17, discussing these options with a psychiatrist or your current healthcare provider, who’s familiar with your case, would be crucial before starting any medication. They can guide you through an initial low-dose trial and gradual dosage adjustments to minimize side effects. Also, because psychotherapy has shown positive results for you, a combined approach – continuing cognitive-behavioral therapy (CBT) alongside medication – may provide comprehensive management of your symptoms. Remember that managing stress, in general, can also significantly aid symptom control. Techniques like mindfulness, regular physical activity, and sufficient sleep can help maintain a balanced mental state. However, any treatment decisions should be personalized by a clinician who can continually assess and adjust your management plan as necessary.

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Dr. Arsha K Isac
I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.
26 days ago
5

Hello

You’ve described your situation very clearly, and it’s encouraging that psychotherapy has already reduced your symptoms significantly. For a 17-year-old with persistent symptoms that still interfere with daily life, adding medication to therapy is a standard and evidence-based next step for managing Obsessive-Compulsive Disorder.

About medications: Both Sertraline and Fluoxetine are commonly used and considered safe for adolescents when prescribed and monitored by a qualified clinician. They do not harm the brain or personality, and many young people take them temporarily while therapy continues.

Side effects: Most are mild and temporary (nausea, headache, sleep changes, slight anxiety at the start). Serious side effects are uncommon, and doctors begin with a low dose and adjust gradually to minimize risk. These medications are not addictive.

Which is “most suitable”? There is no single best choice for everyone, but in adolescents:

• Sertraline is often chosen when anxiety and intrusive thoughts are prominent. • Fluoxetine is often chosen because it has a long safety track record and once-daily dosing. Both are reasonable options; the final decision depends on your medical history, weight, sleep pattern, and response to therapy.

Important practical points: • Continue psychotherapy (especially CBT with exposure and response prevention), because medication works best together with therapy. • It may take 4–8 weeks to see clear improvement after starting medication. • Symptoms often flare during academic or social stress—this pattern is very typical in OCD and does not mean treatment is failing.

When medication is strongly considered: • Symptoms remain severe despite therapy • Daily functioning (study, sleep, relationships) is affected • Distress is high or relapses occur with stress

Your situation—partial improvement but ongoing significant symptoms—fits this category, so discussing medication with a psychiatrist is very reasonable.

Take care Regards

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