Hello,
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I had a look at your prescription (attachment deleted to protect the patient's identity). You have been prescribed effective medication to manage OCD but you are still not getting any relief. Is the problem in your studies due to OCD thoughts or are you feeling tired & not able to concentrate? You are already on a maximum dose of Fluoxetine (SSRI type of medications) which is 80 milligrams day Without complete resolution of OCD symptoms, you have started on Modafinil and Desvenlafaxine by your psychiatrist about 2 months ago. Modafinil will help you with wakefulness. Desvenlafaxine is an SNRI (serotonin and norepinephrine reuptake inhibitors) type of medication that is used as a second-line medication in OCD if Fluoxetine is not very effective. You are already on a good and effective dose of Desvenlafaxine. You need to give a few more weeks to see the maximum benefit from the medication. Are you experiencing any side effects like an increase in anxiety or agitation following medication? In that case, discuss with your prescribing doctor so that the dose can be optimized.
You need to have regular follow-up appointments with your psychiatrist to monitor your response and any potential side effects. Do not make any changes to your medication dosage without consulting your psychiatrist. There are some alternative SSRI medications like Sertraline but it has a similar profile to Fluoxetine. If there is no improvement even after a few months, you can discuss with your psychiatrist whether Sertraline can be considered instead of Fluoxetine. Some people with OCD respond better to Sertraline than Fluoxetine though both are SSRIs. More important is to look at non-medication strategies like CBT which is equally important and effective in managing OCD. You mentioned having CBT before, can you revisit the strategies you learned, and can you apply them in your daily life? Also try relaxation techniques along with yoga, and meditation. Stress makes OCD worse and learning to control stress will help with OCD management. In addition to medications, you also need to follow these strategies for cumulative benefit. It may take time but it will be worthwhile. Vitamin D supplements are good as well.
Finally, remember that you will eventually become stronger than OCD by practicing these healthy exercises. OCD can wax and wane during the course of your life. Do not pressurize yourself too much for your studies. Take time for relaxation and fun activities like exercise, music, and meeting with family and friends. I hope this helps. You can contact me again for any further clarification.