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Question:

My daughter was recently put on Prozac for her OCD, it is pretty severe, she has only been on it for a week now, she has previously been on several other meds for this condition. Anyway, for her benefit and knowledge, even though we’ve been told by psychologists and psychiatrist, she blames her OCD for anger, yelling, rage spitting and hissing, as well as shouting "no, no, no!!!!!" all the time and talking to herself, are these all part of OCD????? Her therapist says some not, at least the anger and rage, but she screams and insists at the top of her lungs that it is all because of OCD and we are just mean and don’t understand, I’d like to have something on paper that says this, what do you think??? Desperate mom

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Answer:

Dear Desperate Mom,

What you are describing can be part of a disorder called Tourette syndrome. There are a few individuals who have a co morbid case of OCD with Tourette syndrome and this could be what is plaguing your daughter.

Tourette syndrome is a little understood neurological disorder that causes the affected individual to engage in repetitive behaviors that very much resemble tics. They can make audible sounds even when in public such as in school and elsewhere. The repetitive sounds and behaviors, such as sudden jerks and motions are not done deliberately. The individual cannot control this behavior and few people believe them.

Your daughter seems to be crying out to you about this and it’s understandable. One of the frustrating things about Tourette is that there is no cure. Sometimes anti depressants, such as Prozac help, but often they do not. Tourette and OCD go together and, just to repeat, are co occurring disorders.

I would suggest that you discuss this with your daughter’s psychiatrist and therapist. I am not stating with certainly that this is what she has but it’s a real possibility. Spitting, hissing, etc can all be part of Tourette.

Another co occurring illness with Tourette is Attention Deficit Hyperactivity Disorder. It might be worth looking into this as well. There are those doctors who prescribe stimulants, used with ADHD, in the treatment of Tourette.

Lastly, even though there is no cure, people can be taught to control their Tourette symptoms in much the same way that they can learn to control OCD symptoms. Behavior modification works well with this.

One week on Prozac is very short and she may start to feel better in another week. It usually takes a month for this medicine to fully reach its strength. Keep that in mind when you speak to her doctors. They may want to wait to see how she does on the medication. However, I would definitely take up the issue of Tourette with them.

Best of Luck

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