r/OCD•
Key-Physics-8973

Medication question, antipsychotics, trial and error

Question about OCD

8 months ago I had a very stressful time at work which resulted in me not sleeping for several days. I was exhausted but couldn't sleep due to constant rumination about my work performance. I went to the ER and they gave me trazodone for sleep. They also connected me with a psychiatrist who started me on lexapro right away. I was finally able to sleep thanks to the trazadone. But the intense ruminations continued and seemed to get worse. The ssri was slowly increased with no improvement. Eventually my doctor added an antipsychotic (seroquel). I felt my thoughts slow a little after starting this med, and it helped with my sleep. I didn't think my ssri was doing anything and began to taper off so that I could try fluvoxamine instead. I noticed my symptoms were a little less intense when I came off the Lexapro, and seemed to increase again as I tapered up the new SSRI. I ended up self tapering back off of it and now am just taking the seroquel. I don't feel normal by any means, but I've had a few moments of relief since the self taper.

I know that issues with ssris are often correlated with bipolar disorder, but I don't think I meet the diagnostic criteria for this. I was never depressed until this started, and I have never experienced mania.

I am wondering if anyone else is being treated with just an antipsychotic? I know it's not typical, and when I researched found that antipsychotic monotherapy is not recommended for OCD and can make things worse.

Part of me wants to taper off that as well to see if things continue to improve without meds. I'm scared to go med free, but really can't tell if they are helping or hurting. Also, yes, I tried ERP early on with little success and am trying it again now. I have a psych appointment coming up and plan to discuss this, but at the same time, I feel like my psych has struggled with treating me. I'm pretty desperate for some relief and hate that the only option seems to be trialing meds and crossing my fingers.

Posted May 29, 2026, 7:55 PM UTC

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