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I am studying at canada. I had been to india for a couple of months recently where I was diagnosed with ocpd. I was prescribed nexito plus initially & after a couple of weeks doctor advised to switch over to nexito 5 mg. Things were more or less in control with the prescribed medicines in india. Now, I am back to canada & still having the medicines. I have increased my physical activity for my improvement but I am finding the panic attack once again returning back. The heart beat also turns rapid at that time. I am unable to understand why it is relapsing once again. I don't have much study pressure right. Can you please tell what might be the underlying cause of the same & what is the remedy.

5 Doctors Answered
Dear lybrate-user, nexito plus contains a benzodiazepine in addition to escitalopram. It was given to you for a couple of weeks so that you get the benefit fast. Escitalopram takes 2 - 3 weeks to act. Now that you don't have benzodiazepine, you feel the fast heartbeat and panic. It is not good to depend on benzodiazepine to relieve your anxiety at this young age. You can learn jacobson's deep muscle relaxation, you can undergo therapy or you can practice yoga and pranayama to manage your anxiety. Having said all these, I would like to remind you that vigorous physical activity increases the heartbeat. You may become panic on catastrophizing it. The remedy is not stopping it. But to wait for heartbeat to normalise after few minutes. It is perfectly normal.
Dear Lybrate user, People with ocpd generally are perfectionists with rigid attitudes and behaviours and also have high conscience in terms of interpersonal relationships and their own life values. These kinds of traits may cause feelings of anxiety/low mood on and off in interactions with others (high expectations from others to comply with). Nothing to worry about your symptoms that you have mentioned. You are in need of psycho education about your condition and there are a handful of treatment techniques from COGNITIVE BEHAVIORAL THERAPY (Relaxation therapies) from which you may benefit to a great extent. You can approach me through Lybrate if you need further help.
The medicine might be working less. You need to consult a psychiatrist either in person or online and escitalopram (nexito) dose may be required to be increased to 10 mg to control the anxiety/ panic attacks. Ocpd/ anxiety have serotonin as the common neurotransmitter implicated. Good luck.
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Ocd •be informed – accept that ocd is a recognised and treatable mental health condition, and that understanding what it is all about is the first step towards recovery. •helping a person with their compulsive behaviours can reinforce their symptoms. However, it is important that the involvement of friends and family in rituals is reduced in a very gradual way as part of an agreed plan with the person or treatment program. •encourage the person to seek help from a professional experienced in treating ocd. Suggestions for supporting the person with ocd include: •offer reassurance that ocd is a recognised and treatable illness. •assist them to be fully informed about effective treatments, including medication and psychological therapy. Information about available options can help alleviate many of the fears that people with ocd have about treatment, such as: how the treatments work, what is expected of the person, how long it should take, what self-management strategies can improve recovery, and how these treatments have helped others with ocd. •encourage them to seek treatment from a professional who is experienced in treating ocd. Fears and worries about treatment may be exacerbated if the person with ocd is exposed to an incompetent or inappropriate treatment service. •don’t try to bully or ridicule a person with ocd into getting treatment – strong-arm tactics won’t work and will only increase their feelings of powerlessness and failure. •emphasise that knowing when to seek help is actually a sign of strength, not weakness. •seek advice from professionals and support groups on your own, if necessary. •sometimes, despite your best efforts, you have to accept there’s nothing more you can do to encourage the person to seek help – in this case, you need to find avenues of support and strength for yourself. •if you think the person is in danger of harming themselves or someone else, call your doctor, •9.Being understanding. Let your friend or family member know that you’re there if they need a sympathetic ear, encouragement, or assistance with treatment. People with bipolar disorder are often reluctant to seek help because they don’t want to feel like a burden to others, so remind the person that you care and that you’ll do whatever you can to help. Exercise one hr daily, oil massage body, hobby, support from friends family, help others, weekly holiday, yoga, meditation tab sertraline 100 mg 1/2 1/2 1.
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You may have had symptoms at an earlier time in your life. Ocpd is a fear-based disorder and if the fear is not identified and dealt with in therapy, you could continue to suffer. I suggest that you seek the help of a counselor too. The behavior will then become based on magical thinking and certain rituals will become necessary to do normal things making you believe that either the frequency or the ritual is important to its success. This of course is a fallacy but there will come a time that even if told the truth, your belief will defy any logic and you will continue behaving like that even if it cripples you in your daily routines. It only appears as though some other force is behind these behaviors and that you are compelled to act in this fashion. That is obviously not true but no one can convince you of anything different. The obsession is a repeating thought pattern with no meaningful outcome; and the compulsiveness is the need to act on those obsessions also in a repeated behavior pattern as though you just cannot help yourself. This is all driven by fear and when you are frustrated with it, you will escalate anger over it. Doubt, insecurity, uncertainty, and lack of firm memory will all plague you and increase stress. There are certain behavioral techniques to be implemented and if they work you may get out of this condition rather easily.
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