SSRIs alone may not work on OCD

Obsessive-Compulsive Disorders » Obsessive Compulsive » SSRIs alone may not work on OCD

Question:

SSRIs alone may not work on OCD A 10 year study found that "40 to 60 percent of patients with obsessive-compulsive disorder do not respond to adequate treatment trials with SSRIs, and agents that alter serotonin receptors and other neurotransmitter systems, such as dopamine and norepinephrine, as well as second-messenger systems may play a role in the treatment of obsessive-compulsive disorder." Treatment for OCD often involves a combination of medications and psychotherapy. Scientists continue to explore which meds help the most, while cognitive behavioral therapy also continues to show promise. Source: Psychiatric Services — Abstracts: Kaplan and Hollander 54 (8): 1111 A Review of Pharmacologic Treatments for Obsessive-Compulsive Disorder Alicia Kaplan, M.D. and Eric Hollander, M.D. OBJECTIVE: Obsessive-compulsive disorder is a chronic and often disabling disorder that affects 2 to 3 percent of the U.S. population. Optimal treatment involves a combination of pharmacologic and cognitive-behavioral therapies. Advances in psychopharmacology have led to safe and effective treatments for obsessive-compulsive disorder that provide clinically significant improvement in symptoms. In this article the authors review studies of pharmacologic treatments. METHODS: A MEDLINE search was conducted to identify relevant articles from 1991 to 2002. Double-blind, placebo-controlled studies as well as open-label studies and case reports were included. RESULTS AND DISCUSSION: The serotonin reuptake inhibitors (SRIs), including clomipramine, fluvoxamine, fluoxetine, sertraline, and paroxetine, have been approved by the U.S. Food and Drug Administration for the treatment of adults with obsessive-compulsive disorder; three of these (clomipramine, fluvoxamine, and sertraline) have been approved for treatment of children and adolescents. Clomipramine and the selective serotonin reuptake inhibitors (SSRIs) are first-line agents. However, 40 to 60 percent of patients with obsessive-compulsive disorder do not respond to adequate treatment trials with SRIs, and agents that alter serotonin receptors and other neurotransmitter systems, such as dopamine, norepinephrine, and second-messenger systems, may play a role in treatment. Treatment options for patients who do not respond to SRIs include switching, augmentation, or novel-agent strategies. Up to two-thirds of patients with obsessive-compulsive disorder have comorbid psychiatric disorders, which may present a challenge in pharmacologic treatment. Major depressive disorder is the most common comorbid condition. Nonpharmacologic invasive techniques may play a role in refractory cases of obsessive-compulsive disorder, but further research is warranted. http://mentalhealth.about.com/b/a/020928.htm ~*~The bad things of life were very transitory. It was the good things,the ribbed sand, the wind blowing over the white capped waves, the sunshine and the stars, that were so tough and durable~*~ ~~Elizabeth Goudge — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Treatment options for patients who do not respond to SRIs include switching, augmentation, or novel-agent strategies.

Seroquel is being used in trials as an adjunct to SSRIs. Of course, the trials are funded by AstraZeneca and money is involved. I do find personally that bits of Seroquel during the day when I get into cycles of obsessions/compulsions do help tremendously. However, it took a long time to kick in–several months. Seroquel blocks the alpha adrenergic-1 and -2 receptors, and thus promotes a calmer mind and halts the hyperactivity. Up to two-thirds of patients with obsessive-compulsive disorder have comorbid psychiatric disorders, which may present a challenge in pharmacologic treatment. Major depressive disorder is the most common comorbid condition.

Same here. The Zoloft has helped the depression about 95-97%. It’s not the greatest OCD med IMO. The Seroquel…and lots of nicotine (which raise dopamine and norepinephrine levels in the brain) handle that much better. — The charter is available at: http://readystump.algebra.com/~asapm