Hi doctor, I am a 36 year old male. I am suffering with OCD and I stammer for past 15 years along with laziness and tiredness all the time. My appetite is not good and so my weight is approximately 53 to 55 kg only. I have changed many psychiatrists in last 15 years. I had Nexito 20 mg, Ciplar 40 mg and Lonazep 25 mg twice a day and a capsule Performax for libido under doctor supervision. Few days back I went to a physician and I told him about my issues. He prescribed me Fluoxetine 20 mg to take in the morning and Nexito 10 mg at night that is 2 SSRIs together. After which my libido was totally reduced. I am single now. So, what should I tell to my partner about my issues? First of all, should I tell or not? Because medications can be life-long and I do not like either my partner or in-laws questioning me for that after marriage. My parents and friends advised me not to tell anything now. Second thing, as I told you, in the past I was having good libido but now it become less. Earlier I used to masturbate regularly but now once in two weeks. Should I get this issue solved before marriage? I had an affair in the past. After break up, sometimes I feel like does not want to mingle with anyone. I faced a lot of negativity in my life and still not able to prepare myself completely for marriage. Please give a genuine marriage.
Hi. I have read the query, and I can understand your concern. You have OCD (obsessive-compulsive disorder) and co-morbid anxiety. The combination of Fluoxetine 20 mg and 10 mg Escitalopram (Nexito) was totally irrational. It is not advisable to take two SSRIs (Selective serotonin reuptake inhibitor) at the same time. Both drugs have the same mechanism of action so using two drugs together increase the risk of side effects only. This was the probable reason that you suffered a loss of libido. In my opinion, there is no need to tell your future partner about the issues related to libido. You can tell your future partner about issues only related to OCD. Anxiety disorders are not the contraindication for marriage. Your libido was normal, and I do not think there should be any problem in the marriage. One broken affair should not cause any hurdle in marriage. One should move away from any past. You are young and have a whole life ahead. Getting married will improve your mood and anxiety. So do not afraid of marriage. Try to look for good examples and avoid thinking about negativity. Ignore anything that causes negative effects on you. It is common in OCD patients to have ambivalence about anything. Try to remain relaxed, these thoughts will reduce with time. Continue to take medicine regularly. Spend at least an hour for exercise, and you will see improvement in mood. The negative thoughts are due to OCD symptoms and depression. With treatment, these symptoms will decrease.