Treatment options

[nonameParticipant]

Hello all, I have some questions regarding treatment, just wondered if anyone can help.

1. Has anyone (in the UK) managed to get medication other than SSRI plus antipsychotic? Either NHS or private? If so, how?

2. Has anyone tried multiple SSRIs with little to no success, then tried another that does work for them?

3. Does anyone have any experience of Danger Ideation Reduction Therapy (DIRT), or know of a way to access it?

A brief background on me, in case it’s relevant. 33, female, OCD almost lifelong but generally very much in the background with occasional self-resolving minor flare ups. Started spiralling 7 years ago. Mostly contamination based. Been seeing a private online therapist for most of 6 1/2 years, for CBT with ERP, also some elements of compassion focussed therapy, ACT and EMDR. Also a psychologist through IAPT (lovely but admitted on first session she was out of her depth with me), then specialist service at Springfield. On SSRIs for most of that time, escitalopram (think this was 15 or 20mg), then fluoxetine (60mg), plus a trial of aripiprazole.

I know it’s the behavioural changes that are needed to improve, but currently I’m so stuck I just can’t do it. My insight is also dropping, and my motivation is rock bottom. I know there are things out there that have worked for some people, from reading (admittedly limited) studies, but because they’re not in the NICE guidelines, it feels like I have a snowball’s chance in hell of getting them. So how do I actually move forward?

Thanks for reading, and if anyone has any advice I’d be so grateful.

[Ray78Participant]

Clomipramine is still prescribed as an alternative to SSRIs. I’ve tried it and several SSRIs unsuccessfully. I’m currently on Effexor – started two weeks ago – which is an SNRI. I’m not familiar with the therapy you mention and as I’m pretty switched on when it comes to treatment for OCD I doubt it’s available through the NHS. In terms of therapy not one therapist in 25 years suggested there were reasons causing difficulties with ERP as an example. I started seeing a therapist three months ago privately who has an integrative approach which includes CBT and Schema therapy and what we’ve discussed is making a lot of sense to me. There are ways of accessing treatment which can include writing letters or even getting your MP involved.

[Author]

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