Posted by Caleb462 on June 15, 2003, at 1:48:22
In reply to Obsessively looking for best OCD medication, posted by leeran on June 14, 2003, at 21:42:13
Anafranil (Clomipramine) is the classic OCD medication, often called the "gold standard". It is a tricyclic, meaning it has sedating and anti-chollinergic side effects, but it is quite possibly not only the best OCD med out there, but one of the best anti-depressants as well. It's an extremely potent inhibitor of serotonin reuptake, and it's metabolite, desmethylclomipramine, is a potent norepinephrine uptake inhibitor. Clomipramine is also a 5-HT2a antagonist. Thus you get multiple Anti-depressant/Anti-obsessional effects from the same drug.
Doesn't work for everyone though, but some patients who don't respond to SSRIs respond to Anafranil.
Personally, I just added Anafranil to my regimen. Started at 25 mg, and am now 50 mg - which is where I'll be staying for a while. Too early to tell what effect it will have on my OCD. I am also on 225 mg Effexor, and 100 mg Seroquel at night.
There's also the atypical anti-psychotics, a percentage of people with OCD respond well to these when they are combined with SSRI/SRI therapy. I believe Zyprexa and Risperdal are the most commonly used agents.. but there is also Geodon, Seroquel, Abilify, and Clozaril. Of course with these you have to consider issues such as Weight Gain, Diabetes, and Tardive Dyskenia... but they are a good choice for some folks.
I belive Buspar augmentation is also helpful for a few OCD patients, and a minority of patients respond to Klonopin augmentation as well.
And of course, there's Nardil - an MAOI.
There's more, just can't remember right now.
Anyway.. good luck, I know how hard OCD can be.
poster:Caleb462
thread:234054
URL: http://www.dr-bob.org/babble/20030614/msgs/234084.html