I'm now taking 20 mg. of Lexapro which knocks out the OCD. For anxiety I take zyprexa, clonazepam and hydroxyzine. I know that's a lot but sometimes even with all that bad anxiety still breaks through. I can't remember everything I've taken for psych meds, but I'll list what I can remember. Tricyclics -- asendin, imipramine, doxepin, pamelor, anafranil. MAOI's -- Nardil, parnate, eldapryl. SSRI's -- prozac, paxil, celexa. Others -- time released lithium, I believe depakote, remeron, wellbutrin, risperdal, abilify. Natural -- valerian, St. Johns Wort, passion flower, tryptophan, tyrosine. I also had ECT when I was in dire straights back in 1998.
Wow, that's quite a list.
I suspect that the Lexapro isn't knocking out the OCD, or doing much of anything. You were on Celexa before, I assume unsuccessfully, and it contain the same active chemical. The only difference between Celexa and Lexapro is that Celexa also contain the mostly inactive isomer too. Plus if it was having an effect on OCD it would be likely be doing a better job of controlling your anxiety levels and depression. Anxiety disorders (including OCD) and depression are differing points on the continuum of affective disorders mediated by the same underlying biology. So I think the OCD is being mostly controlled by the Zyprexa and to some extent clonazepam.
If you're taking clonazepam I don't see the point of taking hydroxyzine too. It is an antihistamine with mild anti anxiety properties which might be adding a bit extra, but nothing that upping the clonazepam dose by 0.125mg wouldn't trump. Unless you're on the maximum 20mg of clonazepam, or there is some other reason why you can't increase its dose, then upping it and dropping the hydroxyzine is going to do far more for your high anxiety levels.
As for the depression, your list doesn't include what is often, with Remeron (mirtazapine), the most powerful antidepressant for very severe depression, Effexor (venlafaxine). If it works well then you may not need anything else for anxiety either, though you may need to still take Zyprexa for OCD as it is the hardest disorder to successfully treat. However, you will probably need to take almost the maximum 300mg/day dose, and may even need to exceed it a bit for good results. Effexor doesn't become an SNRI until the dose gets up to at least 150mg/day, and many need to take 225mg before it begins to inhibit norepinephrine, aka noradrenaline, reuptake. If you, or your doctor aren't willing to go right to the edge then you could be wasting your time. Some of us just need to max out our meds to get good results.
Have you tried Nardil again since it pooped-out on you the first time? If not, it might be worth another shot. Antidepressants can sometimes come back after an absence.
There are two things you need to know about antidepressants. Firstly, they don't work for everyone. IME, about a third get very good results and essentially become symptom free, another third get moderate to good results which are enough to make taking the med worth while, but they will experience some symptoms from time to time, and the remaining third might as well take M&Ms. At least they taste good. Your long list of meds suggests you might be in the treatment resistant third. Secondly, as an added complication there is growing evidence that the more often antidepressants are stopped and restarted the less effective they become, and the greater the odds of total resistance.
I think Effexor is worth rolling the dice for again, and possibly the Nardil too, but your med options are becoming limited. Have you tried the cognitive/behavioural/mindfulness therapies? They can be at least as effective as antidepressants, though the 'rule of thirds' also seem to apply. Just a thought.