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How can I control my habit of cleaning?

Q: I am a 33 years old housewife suffering from ritual cleaning habits. Whenever any outsider comes to my house, I clean the place where he sits. I don’t allow my husband or my daughter to sit any where unless and until they change their clothes when they come from office or school. I spend a lot of time working with water and the consumption of water is huge. The duration of sleeping has reduced. Our sexual relationship is worsening. I was diagnosed with obsessive compulsive disorder (OCD) and asked to take Prodep 60. I have taken the medicine for three months but the problem persists and I discontinued the medicine. What should I do now?

A:You have described features suggestive of Obsessive compulsive disorder with predominant theme of contamination and engaging in cleaning compulsions. I can understand the distress (to yourself and the family) and associated dysfunction. May I suggest the following:

  • Please get your Bl thyroid profile tested.
  • Be regular in your follow-ups with the Psychiatrist.
  • SSRI (serotonin specific re-uptake inhibitors) are known to help. There are different medications within this group. If one doesn't show a good effect, the other needs to be tried but surely underthe guidance of a Psychiatrist and not by yourself. Medications do take a while to bring about an appreciable effect. You have tried Fluoxetine 60 mg/day, which ius also an SSRI. But one needs to be sure about issues of adequate/optimum dosage, compliance, regularity of taking medication before deciding on another SSRI. At times psychiatrists also combine SSRI with clomipramine and other psychotropic medication (monitoring for tolerability) to help their patients from obsessive symptoms. And please do not stop these medicines abruptly, without proper consultation.
  • Cognitive behaviour therapy; graded exposure and response prevention also help and are used in addition to medication for good results.
I suggest a detailed psychiatric consultation and regular reviews with the psychiatrist.

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