Posted by doxogenic boy on September 3, 2009, at 14:56:30
In reply to Re: Rumination and obsessions, posted by uncouth on September 2, 2009, at 16:38:33
> is lexapro better than zoloft or effexor for racing obsessive thoughts?
-------------My psychiatrist has said that Lexapro (escitalopram) probably is more effective against OCD, because of its mode of action. He also say that Seroquel makes the patient tolerate higher doses of Lexapro.
In my experience, racing (obsessive) thoughts need an neuroleptic, such as Seroquel, just a SSRI isn't enough.
This is what I use:
1) quetiapine (Seroquel) 600 mg
2) liothyronine sodium (L-isomer of triiodothyronine (T3); Cytomel, Liothyronin)
20 µg (microgram)
3) escitalopram (Cipralex/Lexapro) 40 mg
4) tianeptine (Stablon) 150 mg
5) clonazepam (Klonopin, Rivotril) 1 mg
6) trimipramine (Surmontil) 100 mg
7) pramipexole (Sifrol/Mirapex) 0.264 mg
(0.088 mg X 3)+++++++++++++++++++++++++++++++
http://www.ncbi.nlm.nih.gov/pubmed/19238126CNS Spectr. 2009 Feb;14(2 Suppl 3):13-23.
LinksNew pharmacotherapeutic approaches to obsessive-compulsive disorder.
Figee M, Denys D.
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Results show that recent developments in the treatment of OCD have been modest and primarily involve evidence for the efficacy of escitalopram and other selective serotonin reuptake inhibitors (SSRIs); augmentation with antipsychotics in treatment-refractory patients and combination treatment with D-cycloserine and cognitive-behavioral therapy has also been effective. The efficacy of serotonin-norepinephrine reuptake inhibitors remains inconclusive.
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++++++++++++++++++++http://www.ncbi.nlm.nih.gov/pubmed/19497245
J Clin Psychiatry. 2009 Jul;70(7):1001-8. Epub 2009 Jun 2.Click here to read Links
Quetiapine augments the effect of citalopram in non-refractory obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled study of 76 patients.
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CONCLUSIONS: The combination of quetiapine and citalopram was more effective than citalopram alone in reducing OCD symptoms in treatment-naive or medication-free OCD patients.++++++++++++++++++++
http://www.ncbi.nlm.nih.gov/pubmed/11543737
Quote from the link:
Biol Psychiatry. 2001 Sep 1;50(5):345-50.Click here to read Links
Second-generation SSRIs: human monoamine transporter binding profile of escitalopram and R-fluoxetine.
Owens MJ, Knight DL, Nemeroff CB.[...cut...]
RESULTS: Both escitalopram and R-fluoxetine were potent inhibitors of the serotonin transporter (K(i) = 1.1 and 1.4 nmol/L, respectively). Escitalopram was the most serotonin transporter-selective compound tested and was approximately 30-fold more potent than R-citalopram. CONCLUSIONS: As noted previously, paroxetine and sertraline possess moderate affinity (<50 nmol/L) for the human norepinephrine transporter and dopamine transporter, respectively. R-Fluoxetine, unlike the other selective serotonin reuptake inhibitors, possesses moderate affinity (K(i) = 64 nmol/L) for the serotonin 2C receptor. Potential clinical correlates of these unique attributes of escitalopram and R-fluoxetine are discussed.
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+++++++++++http://www.ncbi.nlm.nih.gov/pubmed/16953656
1: CNS Drugs. 2006;20(9):763-90.Links
Escitalopram: a review of its use in the management of anxiety disorders.
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Escitalopram (Cipralex, Lexapro, Seroplex, Sipralexa), the therapeutically active S-enantiomer of racemic citalopram (RS-citalopram), is a potent and highly selective serotonin reuptake inhibitor. It is effective and generally well tolerated in the treatment of moderate to severe generalised anxiety disorder (GAD) or social anxiety disorder (SAD), panic disorder (with or without agoraphobia) as well as obsessive-compulsive disorder (OCD). Moreover, escitalopram is at least as effective as paroxetine for the treatment of GAD, SAD or OCD and appears to achieve a more rapid response than racemic citalopram in the management of panic disorder. Generally, it has a more favourable tolerability profile than paroxetine in terms of fewer discontinuation symptoms. In addition, a favourable pharmacokinetic profile permits once-daily administration of the drug. Additional comparative studies are required to definitively position escitalopram with respect to other SSRIs and venlafaxine. Nevertheless, available clinical data indicate that escitalopram is an effective first-line treatment option for the management of GAD, SAD, panic disorder and OCD.
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Please tell me if there are any mistakes in my postsdoxogenic
poster:doxogenic boy
thread:915361
URL: http://www.dr-bob.org/babble/20090902/msgs/915628.html