Do I need to change the drug to treat OCD?

Q: I am 25 years old and suffering from obsessive compulsive disorder since 6 years. I started clomipramine 50 mg and decided to reduce the dose to 25 mg after 6 years as I showed improvement. After 3 months of this reduction, I had a recurrence of symptoms. My doctor advised me to increase the dose back to 50 mg so I did but in vain. What shall I do next? Should I take 75 mg or switch to another drug like fluoxetine?

A:The decisions regarding your dosage are extremely subjective and are different for each person so a generalized opinion cannot be given. You should always try to consult your psychiatrist in person before changing your dosage. Behavioural treatment could also be useful with OCD and a clinical psychologist could be seen with regard to this. If the problem is severely crippling and unresponsive to medicine or any other treatment for over 5 years at a stretch then neuro-surgical techniques can be contemplated but this should be recommended by your psychiatrist and under the conditions mentioned.