u/Ready-Somewhere-3680

I’ve been on 200mg of Luvox (100mg AM/100mg PM) for 10 years for OCD. It’s been my baseline forever, but I’ve been struggling with constant "food noise" and cravings that I’m trying to get under control.

About two months ago, I started 100mg of Wellbutrin to help with fatigue and motivation. It worked great at first, but that "boost" feels like it’s fading now.

My psychiatrist’s new plan is to drop me to 100mg of Luvox (at night) and add 40mg of Prozac (in the morning) while staying on the Wellbutrin.

I’m feeling really hesitant for a few reasons:

1. I don't entirely trust this doctor's intuition.
2. Dropping 50% of my Luvox after a decade feels like a massive jump.
3. Is 40mg of Prozac a high starting point for a cross-taper?

Has anyone dealt with "food noise" on Luvox and found Prozac/Wellbutrin helped? Also, does this taper schedule seem too fast for someone who has been on the same dose for 10 years?

I'm worried about my OCD intrusive thoughts spiking during the transition. Any advice or similar experiences would be appreciated.

I am a 28M and I’ve been on 200mg of Luvox for almost 10 years for severe OCD. It keeps the intrusive thoughts manageable, but the side effect is that I have 24/7 "food noise." I am constantly starving, obsessed with food, and fighting intense urges to binge eat, which is ruining my life.
On top of this, I was recently diagnosed with very low testosterone. My urologist put me on Clomiphene to try and restart it, but it has completely crashed my system—I am dealing with heavy depression, extreme fatigue, and severe mood swings. I also tried 100mg of Wellbutrin a while ago; it worked great for my motivation for a month, but then completely faded.
The Dilemma:
I have a hard deadline. I am leaving the country for a 3-month trip in exactly 4 weeks. I am desperate to stop the food noise before I leave, but my two psychiatrists gave me completely opposite advice:
• Doctor 1: Told me to instantly drop my Luvox from 200mg to 100mg at night, and start taking 40mg of Prozac in the morning to kill the binge-eating urges. (I’m terrified this fast drop/high start will cause a massive withdrawal/serotonin crash right before my trip).
• Doctor 2 (who seems more knowledgeable): Told me Prozac usually isn't as effective for OCD as Luvox, and she is worried my OCD will spiral if I switch. She suggested we leave the Luvox alone, fix the testosterone crash with my urologist first, and look into a GLP-1 medication to safely kill the food noise without touching my psychiatric meds.
My Questions for the Community:

1. Has anyone successfully cross-tapered from Luvox to Prozac? Did it ruin your OCD control, and did it actually help with the food noise?
2. Has anyone used a GLP-1 to specifically treat SSRI-induced binge eating?
3. Given that I have to travel internationally in 4 weeks, would you risk the SSRI cross-taper, or play it safe and address the hormones/GLP-1 route first?

Hey everyone, I’m at a complete crossroads with my mental and physical health right now and could really use some insight from anyone who has navigated a similar stack of issues.
I’m 28, I work out 4 times a week, track my meals strictly, and generally try to keep my system optimized, but right now my "hardware" and "software" are completely crashing. I’m fighting a war on four fronts: OCD, emotional numbness/depression, bottomless binge-eating urges, and crashed hormones.
Here is my current stack and the issues I’m having:
• Luvox (Fluvoxamine) 200mg: I’ve been on this for 10 years. It mostly keeps my severe OCD intrusive thoughts safe, though I still lose time to morning rituals. The massive downside: I have 24/7 "food noise." I am constantly starving, fighting extreme binge-eating urges, and I feel completely emotionally numb with zero libido.
• Wellbutrin 100mg: My doctor added this a month ago to help with the numbness. For the first month, it was amazing—I actually wanted to go out and had energy for the gym. But the 100mg dose quickly faded, and I’m back to feeling unmotivated and exhausted.
• Clomiphene 50mg: My urologist put me on this recently to raise my low testosterone. It has been an absolute nightmare. Instead of energy, I have severe fatigue, intense mood swings, paranoia, and heavy depression. It also poured gasoline on the food noise fire.
I know I need to overhaul this system, but I’m terrified of making the wrong move and spiraling. I’m looking at two different roads right now:
Road 1: The "Add-On" Strategy
• Keep the Luvox at 200mg (since it’s a 10-year safety net for my OCD).
• Raise the Wellbutrin to 150mg or 300mg to get my drive and libido back.
• Get on a GLP-1 specifically to silence the 24/7 food noise and protect my weight/aesthetic.
• Drop the Clomiphene and switch to direct TRT injections for stable energy and mood.
Road 2: The "Core Rewrite"
• Cross-taper completely off the 10-year Luvox and switch to Prozac (Fluoxetine). I know Prozac is highly activating and FDA-approved for binge eating, so the hope is it fixes the OCD, kills the food noise, and gives me my energy back all with one drug.
• Raise Wellbutrin only if the Prozac still leaves me emotionally numb.
• Drop Clomiphene and switch to TRT.
I am really scared to touch the Luvox because I don't want my OCD to explode, but the food noise and fatigue are ruining my daily life. I have to force myself just to get ready to leave the house.
My questions for you guys:

1. Has anyone cross-tapered from a sedating SSRI (like Luvox) to Prozac specifically to stop binge-eating and food noise? Did it work, or did it make your OCD worse?
2. If you stayed on an SSRI that made you hungry, did stacking a GLP-1 successfully kill the food noise?
3. Has anyone experienced this severe depression/fatigue on Clomiphene and found that switching to TRT completely fixed it?
   I just want to feel good, have the energy to enjoy my life, and stop obsessing over food. Any personal experiences with these medications or this specific dilemma would be incredibly helpful. Thanks.