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Re: 5HT-2c and other receptors and targets in OCD

Posted by psychobot5000 on January 24, 2009, at 14:59:29

In reply to Re: 5HT-2c and other receptors and targets in OCD » psychobot5000, posted by SLS on January 23, 2009, at 17:16:40

> Interesting stuff. They sound pretty confident in their commentary.
>
> Look into memantine (Namenda) for OCD. It is a non-competitive NMDA glutamatergic receptor antagonist.
>
> Ever try magnesium?
>
>
> - Scott

They do sound confident, don't they.

I'm glad to hear you suggest memantine--I spent last night (obsessively) looking into what I might do about this--and came across a psychobabble post from a Tourette's sufferer

http://www.dr-bob.org/babble/neuro/20080204/msgs/820576.html

...which quotes that same confident but unsourced passage--among many other articles and medication posts. But the sum of it all was that this poster was helped greatly by Memantine. Looking into all these potential pathways...I had drawn up a list of potential drugs when I read your post, SLS. Memantine was already at the top, followed by tramadol and potentially a low-dose atypical antipsychotic. --It makes me feel much more comfortable to hear someone add their recommendation of it, though--seriously, thank you.

As for antipsychotics for OCD, this 2008 abstract seems to claim they may be the treatment of choice for the 'tic-related' subtype of OCD, which seems relevant.

http://www.ncbi.nlm.nih.gov/pubmed/18386211?ordinalpos=50&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

...From what I read elsewhere, risperidone has the best evidence supporting its use--checked its binding affinities, and it looks like it might have the most 5ht2a action in comparison to 2c and D2. Maybe that could be why. But in any case, memantine seems a safer and possibly more effective option.

As for magnesium--I did try it, a few times, actually--several years ago--for depression, mostly. I Don't remember much about the experience, except that I felt it didn't work very well--I imagine I would have noticed if it had positive effects on OCD, though. ...Interestingly, that unsourced passage that names all the alleged OCD pathways (the one that's so confident) also indicates that NMDA activity is -negatively- correlated to OCD severity--meaning you'd actually want an NMDA AGONIST! Some say that memantine is not an antagonist (as it usually seems to be called), but rather a partial agonist--so perhaps that's why it seems to work better than other NMDA agents for OCD. Here's a quote from the p-babble post I named above, from a quoted a section of another post, touting NMDA antagonists to prevent stimulant tolerance:

"The article goes on to mention DXM, another NMDA antagonist, which I tried, and personally had negligeable success with, and was eventually hospitalized while on it.. it may have exacerbated OCD/schizo-xx tendencies, delusions in my case." (endquote)

Anecdotal evidence that NMDA antagonists ARE in fact bad for OCD? (excluding memantine, obviously) Maybe. In any case, for the moment, Memantine seems the one to try...


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poster:psychobot5000 thread:869924
URL: http://www.dr-bob.org/babble/20090104/msgs/875869.html