Posted by scatterbrained on April 19, 2005, at 22:43:11
Thought this was an interesting article...
Morphine may benefit treatment-resistant OCD patients
Once-weekly morphine therapy can reduce symptoms in some patients with treatment-resistant obsessive-compulsive disorder (OCD), claim investigators."A case series and an open-label trial suggest a role for mu-opioid receptor agonists in the managements of treatment-resistant OCD," observe Lorrin Koran and colleagues, from Stanford University Medical Center in California, USA.
To investigate further, the researchers studied the potential effect of the mu-opioid receptor agonist morphine on the OCD symptoms of 23 patients who had failed between two and six adequate serotonin reuptake inhibitor trials, and had a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of 20 or above.
The participants were randomly assigned to 2-week blocks of once-weekly oral morphine, lorazepam, an anti-anxiety drug, and placebo. Drug doses were increased, decreased, or maintained in the second week of each treatment in accordance with response and side effects.
After treatment with morphine, the median Y-BOCS score fell from 29 to 25, representing a 13% decrease.
In all, seven (30%) patients were considered responders, based on achieving a 25% or greater decrease in Y-BOCS score.
Morphine responders described the relief of OCD symptoms as being noticeable the day after taking the drug and lasting for 2 to 5 days, with symptoms reduced in both frequency and persistence. The patients also felt better able to resist their compulsions.
In comparison, treatment with lorazepam resulted in a median decrease in Y-BOCS score of just 6%, which was not statistically different from the 7% seen with placebo. Moreover, just four (17%) individuals were considered responders after lorazepam treatment, while none of the patients responded to placebo.
The researchers note that, although they did not witness euphoric effects in any of the participants, and none reported euphoria, their study may have been too short for such complications to become manifest.
They conclude in the Journal of Clinical Psychiatry: "The response seen, its rapidity, and the relative tolerability of the treatment are encouraging and warrant larger and longer term studies" of morphine and another mu-receptor agonists for refractory OCD.
J Clin Psychiatry 2005; 66: 353-359
poster:scatterbrained
thread:486761
URL: http://www.dr-bob.org/babble/20050418/msgs/486761.html