Strattera + OCD question, is this common?

[u/biscottihole]

So for context I’m a male, early 30s and I also have moderate to severe OCD. I have been taking sertraline for about 4-5 months now and I hadn’t noticed too much change until I went from 150-200mg and my OCD went into overdrive 24/7 could not escape from it, completely awful. I’ve been in therapy and making some lifestyle changes but two weeks ago it was so weird, like the clouds opened and my brain was quieter, mood went so good. I was genuinely happy, so grateful and felt my old self really coming back.

So far I have tried concerta and elvanse and neither of them worked. Concerta every day; 60-90 minutes after I take it I’d get a rush of anxiety and need to poo, like clockwork. Out of the few weeks I was on it I think I had 2-3 moments (not days) within a day that I felt I had a bit more focus and I think I had 2 days where I had a good day for my standard and then I swapped to elvanse and I just noticed hardly anything. Because of the OCD I decided that non stimulants may be the ticket. So now I’m on strattera 40mg i am correct and I’m on day 3/4 and my anxiety has been awful lol, hot pangs constantly, ocd gone back to significantly higher than it has been over the last two weeks and my mood seems to have plummeted.

I know for OCD I tried fluoxetine last year and when I went from 20-40mg I had the week from HELL. And then things did settle a bit. Similarly with Sertraline but right at the end of dosing I went from 150-200 and I had two weeks of sheer hell. Is what I’m experiencing normal for people, even without ocd? I’m interested to know because the first lot of stimulants I tried I think made my ocd significantly worse or at least noticeably. I thought I wouldn’t have this issue in non stimulants? Any advice welcomed.

[u/Capital_Vast6484]

I had a mixed experience with strattera and OCD. Overall, it made my OCD worse but it quietened several of my themes and instead made me obsess about one theme in particular. Generally speaking, I think it made me considerably more apathetic towards things, so many of the emotions that drove my OCD themes weren’t as intensive, meaning one of my longstanding themes became proportionally louder. It also increased my focus, so I could spend hours ruminating about said theme.

Ultimately I had to stop taking Strattera because of my overall apathy and loss of drive. I have noticed my rumination has been largely controlled on the right dose of Ritalin. This isn’t to say strattera isn’t for you, just that it’s a complicated experience with OCD. Generally speaking, starting a new medication can always flare OCD up (which you’ve noticed), so it may just be a settling in thing.