Posted by Matt on December 2, 1998, at 0:42:40
In reply to Re: Remeron for OCD , posted by Toby on December 1, 1998, at 15:47:04
> Indeed you are correct that Serzone does little for OCD... by itself. It is helpful sometimes in treatment resistent OCD when added to an SSRI. It has something to do with a balancing act between the different subtypes of serotonin receptors (of which there are many). Treatment for OCD relies on boosting serotonin far more than norepinephine and generally the doses of SSRI's are much higher for OCD than for depression. Since the higher the dose of Remeron the more norepinephine it boosts, I don't know if that would affect its ability to help OCD; the balancing act may be important here too. So it remains to be seen if Remeron will be helpful for OCD but I still think it may be helpful as an augmenting agent, even if not all by itself, like Serzone.
> Thoughts from other docs?Not a doc, but from what I read and my own experience, mixing SSRIs and Serzone produces bigtime anxiety. I'm surprised to hear that you've mixed the two. Also, I take it you mean that the increase of norepinephrine in the synapse as one ups the dose of Remeron isn't a linear function of the dose of Remeron? From what I understand about Effexor, it is this way too, one gets a nonlinear increase in the amount of norepinephrine as one ups the dose of the drug. Does Effexor look to be less effective for OCD in higher doses, then? Or does the increase in serotonin somehow outweigh this nonlinear increase in norepinephrine?
Matt
poster:Matt
thread:1409
URL: http://www.dr-bob.org/babble/19981201/msgs/1430.html