Dear Dr. Williams, I visited a psychiatrist yesterday and I got diagnosed with HOCD. He prescribed me medication. I am worried about the side-effects of the medicine. Will I destroy part of my brain's functionality 4good? What about erectile dysfunction?

Dear friend, don't worry, the medication (probably an SSRI antidepressant) will not destroy your brain function. Side effects tend to be few (sexual dysfunction being the most annoying), but if there are problems you can always just stop the medication or try a new one. Also, for sexual dysfunction, Viagra or a similar drug can usually do the trick
That being said, people who stay on these medications for a long period of time can have difficulty stopping them later. Headaches and other withdrawal symptoms can occur. The medications do change the way the brain functions (ideally for the best), but your brain may have trouble adjusting once you stop.
You might consider cognitive-behavioral therapy for your OCD instead. It is free of side-effects and more effective.
Best of luck,
Dr. Williams

Thank you, Dr. Williams. I am just 26 years old. Is erectile dysfunction still possible? And are we talking about total inability to achieve an erection? What are the chances I will get it? The medicine is indeed an SSRI antidepressant, it's called Dumyrox.
The psychiatrist told me I should follow the medication for at least one year for the obsessions to vanish completely.
My brain has been overly creative to the point that I have some inability to concentrate, I ruminate a lot and not only about HOCD (I do have religious concerns in OCD fashion, etc). On the other hand, my overly creative brain offers me a great sense of humor, strong imagination, easiness to answer fast and effectively, very fast reflexes, quick perception of surrounding circumstances.
Do SSRIs slow down or even hinder these functions in any way?
Thank you once again!

Dear Dr. William,

My son is 21 years. About four years ago - when he was a teenager - we noticed he could jerk his hand or have a funny movement on his face, something like twitches. We visited a neurosurgeon who prescribed something which we can't recall. Later, we noticed he had a terrible anger outbursts and could bang doors or break things. He also would take lots of time in the bathroom showering. We visited a psychiatrist who diagnosed OCD. He put him on zoloft 25 mg. However, the twitching on his face and hands could not disappear. They have got worse. he is also fearful of many situations. a clinical psychologist has been seeing him and she says he will get over it. But his condition is not improving. Another psychiatrist suspects it could be tourette disorder. he has prescribed risperidone 2 mg up from 1mg in a week. My son has been an extremely brilliant and diligent. We are now worried. He is also worried about his future. He fears for his future - that he is not capable or that the medication will make him useless. We are also worried about the medication and whether it will mess him. Should he withdrawal?

Hi Henrik,

I can certainly appreciate your concerns regarding your son. Have you discussed your concerns regarding the side effects of risperidone with his psychiatrist? I do not recommend that you discontinue the medication without talking to his doctor first.

I am wondering why two different psychiatrists are treating your son. (Perhaps they work at the same clinic?) It is important that his treatment providers (the psychologist and psychiatrists) are communicating with each other and on the same page regarding his treatment.

While it is not uncommon for antipsychotics to be prescribed for Tourette's symptoms, other types of medications are used as well. Risperidone, like all antipsychotics, can potentially have various side effects, ranging from mild to serious. However, it won't necessarily make him "useless". It can cause drowsiness, which may affect his mental sharpness at times.

You may want to discuss alternative medications with his psychiatrist. Ultimately, your son, as an adult, will need to decide whether or not the benefits outweigh the risks and side effects of any medication he is prescribed.

Henrik,

Antipsychotic medications are the primary medications used for the treatment of Tourette's. Others that are sometimes used include Catapres (clonidine hydrochloride), clonidine hydrochloride, Tenex (guanfacine) - alpha 2-adrenergic agonists, and the hypertensive medication clonidine.

I really cannot say which medication would have the least side effects, because side effects vary from one person to the next. And, it may be that these other medications are not appropriate options for your son based on medical history, specific symptoms, etc. Risperidone or another antipsychotic may, in fact, be the best choice for your son.

I don't know if your son's condition will improve or not. There is really no way to predict that. With plenty of support and ongoing treatment, he may be able to complete his education. Many people successfully complete college in spite of the challenges of a psychiatric disorder or medical condition.

I do recommend that he continue with psychotherapy, and that one of the treatment goals is to learn ways to manage his symptoms, as well as manage stress - stress can make the symptoms of Tourette's and OCD worse.

You may also consider having your son evaluated by a second psychiatrist in order to obtain a second opinion regarding diagnosis and treatment. I strongly encourage you to be very open about your concerns and ask questions when you talk to his psychiatrist.

I wish I could offer more. I'm not a psychiatrist so medications are not my area of expertise. But I do always feel it is worth considering all options and discussing your concerns and fears with his psychiatrist.

Henrik,
My apologies for not getting back to you sooner. Rather than list all the side effects here, I am going to refer you to these two links:

For Catapres: http://www.drugs.com/sfx/catapres-side-effects.html

For Tenex: http://www.drugs.com/sfx/tenex-side-effects.html

Keep in mind that drug companies are required to list all known potential side effects, even if some of them occur in only an extremely small percentage of people.

I hope this helps!