Posted by Cam W. on October 31, 2000, at 6:56:22
In reply to Cam or anyone, Anafranil better for OCD?, posted by Trish Baker on October 30, 2000, at 1:23:53
Trish - Anafranil™ (clomipramine) is a TCA with very strong serotonin reuptake (SR) blocking activity relative to it's norepinephrine reuptake (NR) activity. In fact clomipramine is almost a SSRI, except it does have some extra side effects (eg cardiotoxic properties, dry mouth, drowsiness, etc) that SSRIs lack, due to binding to alpha-1 adrenergic an cholinergic/muscarinic receptors (albeit less so than many other TCAs).
Clomipramine is similar to Paxil in binding affinities to SR and NR. Serotonergic antidepressants seem to work well in cases of OCD (as well as panic, social phobia, & PTSD). The problem with SRI drugs in OCD is that they can take a long time to work (eg 26 weeks to see a 50% reduction in obsessions and/or compulsions). Most people give up way too soon (actually, a couple of tears ago, I would probably have said to abandon a drug that seemed marginally work for OCD symptoms, but I have seen more than one person have these delayed results.
In theory Celexa™ (citalopram) should work for OCD, but before combining it with Anafranil, maybe ask your doc about increasing the Celexa dose, first. Ask your doc what he/she feels more comfortable doing.
Relapse of OCD symptoms after stress is common. Perhaps some sort of psychotherapy to deal with the added stress can help the Celexa work better. Again, ask your doc.
Hope this helps - Cam
poster:Cam W.
thread:47742
URL: http://www.dr-bob.org/babble/20001022/msgs/47806.html