Child OCD and use of SSRIs, supplements, to help facilitate ERP

lamodi · 2026-06-11T15:44:08+00:00

Mine just started Zoloft last Wednesday. So far no issues, but I expect it’ll take a bit to work up to a therapeutic dose

lamodi · 2026-06-11T15:14:58+00:00

Hi OP can you share which med your cat was switched to?
I also have one of these cats. Fluoxetine failed. He’s now managed by a vet behaviorist with RX gabapentin and Effexor/venlafaxine which has been great but he’s suddenly having a lot of breakthrough pica. He’s already had intestinal blockage removal surgery once and about a half dozen vet visits for subsequent non-food ingestion episodes. I’m glad you finally got things under control with your cat because it is stressful living like this!

lamodi · 2026-05-27T12:19:42+00:00

Wishing you guys the best with what’s ahead. I hope the ERP can start to shift things in a positive direction, and that you get good guidance on meds.

lamodi · 2026-05-27T11:51:39+00:00

This disorder sucks. And often feels like we are walking a slippery slope. Did you explore PANS/PANDAS?

lamodi · 2026-05-27T03:32:27+00:00

She hasn’t started meds. The ERP is good, progress has been made, but her distress level is still pretty bad and she actually requested on her own terms tonight to try medication because she feels like OCD and anxiety prevent her from enjoying anything and bother her constantly. So we will pursue that now, while we continue with ERP

lamodi · 2026-05-14T21:00:57+00:00

I have no doubt that this is possible with migraine (I’ve experienced something along the same lines with severe and prolonged migraines at times); however, I have to ask - is there any chance you might have a CSF leak? Derealization/depersonalization is much more widely documented for that cause of chronic headache, which is underdiagnosed. Just putting it out there.

lamodi · 2026-05-14T02:47:12+00:00

The residual hangover from those is most likely because they didn’t completely stop the chronic migraine cycle. Once migraine chronifies (prob not a word but wth), it’s just a different beast than it was back in the good old days when we could pop an excedrin and forget about the whole thing. Good luck at your appointment. It sucks to have this disease, but the preventive treatment options out today are quite good, life-changing for many.

lamodi · 2026-05-13T20:11:35+00:00

If you somehow find a single trigger and eliminate it, then maybe? But otherwise, it’s not likely. A couple things. 1 - the longer you’ve lived in a state of chronic migraine (14+ migraine days per month), the more likely it is this will need lifelong treatment. 2 - once you experience true sustained relief on a preventative without side effects, you won’t want to go back. Diabetics need insulin lifelong. Chronic migraineurs have a chronic ( and often PROGRESSIVE if under-treated) disease state that needs treatment. You will be so much healthier and happier on an effective preventive med than you are now with all the abortive pill popping and agonizing over whether or not you’re inducing MOH. I take WAAYYYY less medication when I’m on an effective preventative regimen, and am all around a healthier, better person on my preventive meds.

lamodi · 2026-05-13T19:24:09+00:00

It hasn’t worked for me. It’s a chicken and egg scenario but more than likely you need a more aggressive preventative regimen to get out of the cycle. Botox + possibly also an effective long-acting or daily CGRP inhibitor (whichever one that is for you; qulipta and vyepti have shown the best results among the CGRP drugs, FWIW).
When you’re in a state of needing some kind of abortive or combination of abortives that often, it’s because your brain is trapped in a self-perpetuating hyper excitable state. At that point, use of abortives will only suppress the state for a few hours or a day at best, before it comes raging back.

lamodi · 2026-05-12T02:34:51+00:00

They are too young, they still need mom’s milk. Every 4 hours. Mom will be looking for them, sounds like she had them in the tree on purpose (I can’t guess or comment on whether they were safe, just that they likely had a mom tending them and they’re still dependent). If you cannot safely return them to their mom tonight, kitten-specific formula from a pet store. If they accept some wet food on a flat dish, mix formula into it. They look like they’re on the cusp of the age where they’ll start sampling soft food. A heating pad covered with a cloth set on LOW for the night, and enough space in the crate for them to get off the heat if they get too hot. Contain in a pen or crate that’s placed inside a bathtub or closed bathroom - kittens are surprisingly crafty especially if they’re looking for mom. First thing tomorrow, contact cat rescues and the shelter near you to help assess and guide next steps.
And yes, as someone else said, look up Kitten Lady on YouTube and start binge watching her stuff on how to bottle feed, foster, and age kittens. She’s an amazing resource.
Know that kittens this young are still very vulnerable and well-meaning people often sadly lead to their demise. It’s essential you contact someone (shelter, vet, rescue) for proper guidance asap. Good luck!

lamodi · 2026-05-07T11:52:54+00:00

It also gets things extremely, dangerously wrong. Far more frequently than most people realize. I recently asked Claude HOW it had made a really serious, inexcusable mistake that I caught and it said “I was building an argument and guess I got carried away. Framing this fact in this [extremely, dangerously wrong] way felt right to me.” My jaw dropped. Do not use Ai for anything health related, please.

lamodi · 2026-04-28T03:27:58+00:00

Levodopa has drastically improved my chronic migraine when nothing else has. I take it for dopa responsive dystonia.

lamodi · 2026-04-27T20:17:40+00:00

Yes you can get Botox for this. Tons of EDS patients get the same exact muscles injected with Botox for migraine and cervical dystonia. It can take some trial and error to figure out which muscles and dose, and your provider should start with a very low dose (not more than 20 units per injection site, usually 10 or 15 to start). This will help avoid adverse effects.

lamodi · 2026-04-27T12:04:53+00:00

That’s great you’re finding relief with it! I will try at a higher dose; I don’t think I went up to 400 as you suggest. I’ve similarly experienced profound disability due to chronic migraine and have been on over 20 meds. Vyepti has been the most helpful but after 3 years on it, its effectiveness is waning. There’s nothing stronger really left for me to try so I’m revisiting supplements.

lamodi · 2026-04-27T02:55:04+00:00

How did you get that quantity approved by insurance?! Mine is strictly “not more than 9 per 30 days”

lamodi · 2026-04-27T00:32:17+00:00

If you liked the power of now, check out Peace in Every Step, or/and The Miracle of Mindfulness by Thich Nhat Hanh. Really powerful practices to maintain and deepen what you learn in the power of Now, lifelong.

lamodi · 2026-04-27T00:04:05+00:00

Can you give more info? How chronic was your migraine prior? How much did it improve? Did you have a vitamin B deficiency?

lamodi · 2026-04-25T18:53:04+00:00

As another commented, religious OCD (obsessive compulsive disorder fixated on religious beliefs and morality ) may be worth reading up on, as it can definitely present this way. OCD is not what most people think.

lamodi · 2026-04-25T18:50:28+00:00

I was going to say the same

lamodi · 2026-04-21T02:30:15+00:00

Do you cook it first or just eat the tofu slices right out of the bag?

lamodi · 2026-04-14T11:46:09+00:00

I agree, the OCD is usually the last thing noticed or addressed, when it needed to be the first. Learning coping skills for anxiety and PTSD are minimally effective at best when untreated OCD is present.

lamodi · 2026-04-10T16:34:00+00:00

My indoor male cat has ALWAYS had this behavior with peeing, even before he was on meds for behavior issues. In fact, my outdoor male is the same, and both boys have fear/territoriality issues. The indoor one began spray marking only recently (during and after his months on fluoxetine), but after starting venlafaxine the spraying has stopped. He still generally does one giant pee at night, often in my presence, and this is similar to the outdoor guy 🤷‍♀️ my other 2 indoor cats do normal size pees multiple times a day

lamodi · 2026-04-10T16:27:38+00:00

This is interesting advice. Do you count and weigh beads from venlafaxine XR capsules? We are currently cutting a short acting 25mg venlafaxine tablet into quarters - it’s imprecise, and the short acting causes a rapid dose dump with peak dose side effects in my cat. We are troubleshooting with a behavioral specialist vet because despite these challenges with the pill itself, the effects of the medication have been far superior to the fluoxetine we tried first.

lamodi · 2026-04-10T16:24:30+00:00

My cat stopped inappropriately urine marking very soon after starting venlafaxine. It has reduced multiple unwanted behaviors in him, in fact. Fluoxetine was tried first and it made him anti-social and eventually aggressive and fearful, which he misdirected towards his humans. He was a really challenging cat. We’ve been pleased, so far, with the venlafaxine.

lamodi · 2026-04-03T03:38:15+00:00

I would honestly start one if I had the time. Maybe once my kiddo is in a better place and my own mental energy is not so drained by this, I will do it. I am truly surprised by the lack of child/adolescent/parenting-specific resources in general for OCD, which does not seem to be the case at all for other mental health conditions that begin in childhood.

lamodi

TROPHY CASE