my psychiatrist supports me seeking further treatment for refractory ocd but feels she is not familiar enough with some of the medications.Would speak I to a neurologist first or palliative care doctor?All else has failed

Submitted by ocdeed Thu 02/10/2011

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Hi Ocdeed, Without

Submitted by Dr. Lane on Fri, 02/11/2011 - 1:07am.

Hi Ocdeed,
Without knowing more of your history, my first question would be do you truly have refractory OCD? I encourage you to read the article entitled "Treatment Resistant OCD" on this site - scroll down the menu on the left side of the page to find it. You may have already gone over all of that, but I suggest it just in case you don't really fit the clinical picture of refractory OCD.

Have you had treatment besides medication for your OCD? I am a firm believer from both my training and years of experience that psychotherapy is a very important part of treatment for almost all disorders, and that medication alone is usually inadequate.

If you do meet the criteria (and few people really do - most people haven't had the right type of treatment or give up too quickly) for refractory OCD, then you would most likely need to consult with a neurologist or neurosurgeon, particularly if you are considering psychosurgery as a treatment option. I doubt a palliative care doctor would have much to offer, but I could be wrong.

I also recommend you get a second opinion, preferably from a psychiatrist or psychologist who specializes in the treatment of OCD, if there is someone like that in your city (unless this is already a second opinion or your current psychiatrist specializes in treating OCD).

OCD is often a very difficult disorder to treat, and most people don't get the type of treatment they really need. Unfortunately, this can lead to the belief that they are treatment resistent, when that isn't really the case.

I personally think OCD is a disorder that is best treated by someone who specializes in treating it, and who has successfully treated others with OCD. But I do realize you may not have access to someone like that.

I hope this helps and I wish you the best in whatever direction you choose to take at this point. I am also deeply sorry that nothing has worked for you thus far. I hope that you are able to find something that does.

—

Dr. Lane

For Treatment Options Call (877) 331-9311

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