This community looks pretty dead, so I'm gonna post in the hope of livening it up a bit. I'd love to hear about the efforts other people are making to remove the burden of OCD from their lives.

TL;DR: I am starting to think Fluoxetine may actually be having a noticeable positive effect, and I would like to encourage anyone with reservations about SSRIs, or who may be thinking of giving up on it, to give it a chance.

Talk therapy and CBT have never really made a significant or lasting impact on the mental blocks OCD creates for me on a daily basis. I put off trying Fluoxetine for a very long time, solely because of an absolutely horrendous experience I had with another SSRI (Venlefaxine) many years ago. The time I was on it was almost as bad as the weeks I spent weaning off it. After reading a lot of posts from other people comparing SSRI experiences, and seeing Venlefaxine consistently ranked the lowest in efficacy and highest in side–effects, I started to feel a bit more confident about starting Fluoxetine. I'd reached a point in my life where a combination of factors had made life a living hell as well, so I was at peak "fuck it, might as well".

I started at 10mg a day. My directions were to continue that for the first week, then step up to 20mg. Like an idiot, I decided to speedrun to 20 on my third day. Also like an idiot, I decided to take it the moment I woke up, and put off eating until a couple of hours later. Two lessons quickly were learned from this.

• Fluoxetine has a long half life, and the reason you start low is because your body is adjusting to an accumulation of the drug over the course of the week. Rapidly increasing your dose will also rapidly increase the onset of the side–effects one feels while adjusting to the drug. This includes an increase of the symptoms the drug is ultimately supposed to suppress. My anxiety was off the charts. I was in fight–or–flight mode from late morning to well into the night, stomach in knots, and sleeping extremely poorly, if at all. It should be the most obvious advice, but for anyone else prone to stupid decisions like the ones I make, please take the drug as directed.

• Your stomach may also need time to adjust to the drug. This probably won't apply to everyone, but I personally regretted taking it on an empty stomach so much that I made that mistake exactly once, and now ensure that I have at least a little bit of something in me before I take my pill. If you do fuck up like I did, I recommend a ginger capsule and an antacid. Seemed to calm my stomach down enough to at least stop writhing around in pain for the rest of the afternoon.

On to the positives now. I'm on day 18, still taking 20mg Fluoxetine XR each morning after breakfast. By all accounts, this is still quite early in the adjustment period for this drug. Most people report an awareness of the intended effect, while still experiencing some of the unpleasantness such as fatigue, nausea, and anxiety. This is consistent with what I'm going through right now. It sounds a bit nonsensical, but while I do feel an unshakeable sense of dread, and I am having bouts of inexplicable irritability, I'm also distinctly aware of my new ability to shake off the anguish of everything being "wrong". Things not happening in the right order, things being in the wrong place, making a minor mistake — in reality these mistakes are just minor deviations from an established, arbitrary process — are easier to move past. I'm able to say "oh well" to stuff that could have completely derailed my day prior to starting this drug.

One thing that really gets me down at the moment is the fatigue. My sleep issues are seemingly calming down. I find it easy enough to get a continuous 6 hours, which for me is pretty huge. I wake up with a spring in my step and get a lot done in the first few hours, but by 6 hours in I'm faced with a choice of either taking a nap or dragging myself through what remains of the day, fantasising about just curling up and switching off. Again, this seems common, with most saying it goes away after 6 weeks, and a minority saying it took them a couple of months. I'm pinning all my hopes on having this same experience. I'm following up with my doctor tomorrow to discuss my dosage, and whether the fatigue could be mitigated in the short term with Bupropion (Wellbutrin), as it commonly is for people in my position.

The key takeaway is that Fluoxetine is a hellish drug to start out on, as all SSRIs seem to be, but it really seems to be making me not only less depressed, but less obsessively compulsive. I encourage others to consider it, even if they've had poor experiences with SSRIs in the past. However, if you're working full time, try to get some time off in your second and third week. If you can't, start out with the lowest possible dose and increase very slowly. I am not employed currently, and can't imagine holding down any job in this state.

Hello all, I’ve come with info about medications. First off, do not settle for a med provider who is not a psychiatrist, you NEED a psychiatrist. So one thing is if you have not taken or tried Prozac (fluoxetine), you probably should it’s the first line SSRI for OCD. Some family docs or whatever you are using if it’s not a psychiatrist might give you sertraline first because it’s a safe option. That is the wrong drug to try first, Prozac should be the first thing to try (it is first line). I had an NP prescribe me sertraline and never even thought to try Prozac. I kept asking to see a psychiatrist until they finally fit me in, and my meds were completely fucked up.

My meds are now getting fixed by this psychiatrist and I feel WAY better. This is why I keep saying to get a psychiatrist, I think it’s super important for us for recovery. Here’s me saying it again: meds for OCD are complicated, you don’t just have anxiety, you have OCD, get a psychiatrist and don’t stop pestering them until you get one.

SSRIs has a side effect that is super common. The one I want to tell you about is usually misunderstood. People usually say it kills your libido and you’ll have no sex drive. SSRIs don’t kill your libido, they make it hard to finish. Another thing that is important to know about SSRIs that might not be communicated well is that it takes roughly 1-2 months for the medication to build up and start working. This fucking sucks, but you can do it I fully believe in you, whoever you are.

This is some stuff I’ve learned that I wanted to pass on. Again meds are complicated and meds might take some trial and error not everyone is the same, get a psychiatrist. There is hope I mean it, please please please don’t lose hope.

I’m going to list some tips, if other people want to add feel free.

1. Get a diagnosis from a professional
2. Make sure your med provider is a psychiatrist this is extremely important as NPs are using their union to force through strange legislation.
3. Take your meds, they will help. And if they don’t, tell your psychiatrist there are always options.
4. Make sure your therapist of choice knows how to actually treat OCD. The current gold standard is ERP.
5. Know you aren’t unique, there are themes because everyone always falls under one or more of those umbrellas.
6. Know you will get better and stay hopeful.

Thanks my spiel for the first post in the community. Stay safe guys and I’m rooting for you.