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Re: Agomelatine and Tranylcypromine for OCD

Posted by linkadge on March 13, 2011, at 17:53:38

In reply to Re: Agomelatine and Tranylcypromine for OCD, posted by Dr. Fischer-Terworth on March 13, 2011, at 12:29:29

A 5-ht2c antagonist could theoretically increase OCD like behavior. Although fluoxetine is a 5-ht2c antagonist, it is also a SSRI. In other words, the net effect is 5-h5t2c agonism (I believe). Most SSRIs are 5-ht2c agonists, and there are case reports of drugs like cyproheptadine (combined 5-ht2a/c antagonists) causing relapse in OCD patients on SSRIs. Also, there are reports of 5-ht2a/c agonists like tryptamine, mescaline etc. rapidly improving OCD symptoms.

Another (theoretical) possiblility is potentiation of 5-ht1a mediated neurotransmission and possible serotonin syndrome. If you haven't experienced this yet, the risk seems low. However, since certain sertonergic antagonists (like antipsychotics) can increase 5-ht1a mediated effects when combined with SSRIs, the risk with combination with agomelatine is a possbililty.

You might find that simply taking periodic breaks from the agomelatine (or reducing the dose) is sufficent to regain the anti-ocd effect.

Linkadge


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URL: http://www.dr-bob.org/babble/20110220/msgs/980438.html