Posted by King Vultan on December 28, 2004, at 8:01:41
In reply to Prozac and Risperdal for OCD and Depression, posted by tim100 on December 27, 2004, at 19:38:16
> Has anybody had any luck with the combination of Prozac and Risperdal for OCD and Depression?
>
> I have tried every other SSRI in the book for dealing with OCD and nothing really worked. My current Med combo is 60mg Prozac / 1mg Risperdal / 1mg ativan 4 times a day for anxiety.
>
> How about celexa? I've heard that celexa is good in high doses for OCD but I was only on 40mg a day when I took it.
>
> Tim
Atypical antipsychotics are sometimes prescribed at low doses to augment SSRIs and other drugs that increase serotonin transmission, such as MAOIs. Treating refractory OCD seems to be one of the chief reasons to do this. I have just started taking low dosage Risperdal, currently 0.25 mg/day, to augment my Parnate. In my case, it is not so much for OCD, as it is to counteract some other negative effects I am getting from overstimulation of the 5-HT2A receptor, such as insomnia, sexual side effects, and a bit of agitation.While your dosage of Risperdal is in a range generally associated with augmenting antidepressants (0.5-1.0 mg/day), the fact that you are also taking Prozac, which is a strong 2D6 inhibitor, is likely increasing the blood plasma level of the risperidone to a significantly higher level. My guess is that it is high enough that your blood plasma levels of the Risperdal are actually well into the antipsychotic range. This is not necessarily a terrible thing, but it does suggest that further increasing the Risperdal would be futile and imprudent.
I've suffered from OCD in the past and have managed to get a pretty good handle on it with the aid of SSRI-type drugs, while also continually working on it in a cognitive sense to defeat the problem. I accomplished this pretty much on my own, but I think drugs + cognitive therapy is the best way to conquer OCD. I cannot say I've really noticed much difference in OCD efficacy between any of the drugs I've taken that increased serotonin transmission, other than that Parnate, which is also quite dopaminergic, seems to work better than the other MAOI I've tried, Nardil.
Todd
poster:King Vultan
thread:434720
URL: http://www.dr-bob.org/babble/20041228/msgs/434937.html