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Dr. Bob is Robert Hsiung, MD,
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Posted by temoigneur on February 10, 2007, at 2:17:10
Pharmacopsychiatry 2005; 38
DOI: 10.1055/s-2005-918680
Amantadin reduces activation of the cingulate gyrus in patients with obsessive-compulsive disorder: a LORETA based study
S Feutl1, Y Zhang1, P Schmorl2, U Hauser1, J Schramm1, HM Emrich1, DE Dietrich1
1 Abteilung für Klinische Psychiatrie und Psychotherapie, Medizinische Hochschule Hannover
2 Abteilung für Psychiatrie und Psychotherapie, Vivantes Auguste-Viktoria-Klinikum, Berlin, Berlin
Amantadine is used as an effective compound in a variety of psychiatric disorders, though its clinically relevant pharmacodynamic properties are still unclear. In this study the influence of amantadine on obsessive-compulsive symptoms and attention deficits in patients with OCD (n=12) was investigated in a placebo-controlled trial using visual event-related brain potentials before and after 8 weeks of treatment. The stimulus material consisted of letters H and O with two varying sizes (larger ones as targets requiring response by pressing buttons, smaller ones as non-targets) in a go/nogo paradigm. Neural generators of the brain activity were estimated by computing the cortical distribution of current density with the LORETA algorithm. Statistical comparison for the target P3b (460–680ms) using the „statistical non-parametric mapping“ option for activity revealed significant lower localized brain activations of the cingulate gyrus within the amantadine group after treatment (p<0.05; BA 31) but not within the placebo group (p=0.61). Moreover, the reduction of the parietal P3b correlates with a decrease of obsessive symptoms in the amantadine group (r=0.82, p<0.05). Regarding to the deficits in high-order cognitive processes associated with OCD it has been hypothesized that hyperactive corticostriatal circuits constitute the underlying pathophysiology. Our findings suggest that amantadine could reduce this hyperactivation whereas the detailed mechanism remains to be discussed.I was wondering, Clomipramine is the only drug that has given me long term relief from OCD,at the expense of my creative side and .... well intellect. Perhaps Larry or Link are familiar with the mechanisms by which Clomipramine helps with OCD, my question is, is the regulation of activity described in this article similar to the therapeutic effects of clomirpamine in any way. I have comorbid OCD and inattentive ADHD, could starting at a low dose of liquid amantandine and increasing in maybe 25mg/week increments bring about the same therapeutic relief I experience with clomripamine without the mallet- to head side effects... *in addition to activating faulty dopamine circuitry and perhaps helping with ADHD as Dr. Singer and Holllinger report. Thanks
Ben
Posted by linkadge on February 10, 2007, at 9:08:31
In reply to Amantadine reg. activity in cingulate gyrus 4 OCD, posted by temoigneur on February 10, 2007, at 2:17:10
I would tend to think that most effective treamtments for OCD achieve their theraputic effect by altering regional brain metabolism. I think that theraputic response to SSRI's is also associated with dampening of similar circuits.
The idea that OCD was a disorder of low serotonin is kind of old. The net goal in altering monoamines is probably the same as the intercellular actions of amantadine.
OCD with comorbind ADHD can be difficult to treat as stimulant drugs often have the side effect of increasing directed attention and sometimes "obsessive circutry"
I would start with treating the most distressing of the two diseases fully, and then look to treat the second, hopefully without bringing back the first.
Linkadge
Posted by Phillipa on February 10, 2007, at 11:13:30
In reply to Re: Amantadine reg. activity in cingulate gyrus 4 OCD, posted by linkadge on February 10, 2007, at 9:08:31
So luvox is no good for OCD? Love Phillipa
Posted by linkadge on February 10, 2007, at 11:28:06
In reply to Re: Amantadine reg. activity in cingulate gyrus 4 OCD » linkadge, posted by Phillipa on February 10, 2007, at 11:13:30
No I'm not saying it won't work for OCD, I'm just saying that saying that OCD is due to low serotonin is too simplistic.
Linkadge
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