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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Phidippus on May 19, 2010, at 18:03:39
Who here thinks they know what atypical antipsychotic is best for treating OCD?
P
Posted by SLS on May 19, 2010, at 19:19:55
In reply to The best atypical antipsychotic for OCD...?, posted by Phidippus on May 19, 2010, at 18:03:39
> Who here thinks they know what atypical antipsychotic is best for treating OCD?
I read something about risperidone (Risperdal) quite awhile ago. It might be worth looking into.
- Scott
Posted by morganator on May 20, 2010, at 1:13:26
In reply to The best atypical antipsychotic for OCD...?, posted by Phidippus on May 19, 2010, at 18:03:39
Are you just using an atypical for OCD? Are you bipolar or schizophrenic/schizoaffective? I would think twice before using an atypical antipsychotic unless you need it for mania, severe depression, or psychosis. They just suck in general IMO.
What about Memantine? Now that's a good drug may work well for OCD.
Posted by Phidippus on May 20, 2010, at 10:43:09
In reply to Re: The best atypical antipsychotic for OCD...?, posted by morganator on May 20, 2010, at 1:13:26
> Are you just using an atypical for OCD?
The APA recommends augmenting anti-depressant treatment with an atypical antipsychotic.
>Are you bipolar or schizophrenic/schizoaffective?
I am bipolar as well.
> What about Memantine?
It did little for me.
P
Posted by Bob on May 21, 2010, at 19:57:07
In reply to Re: The best atypical antipsychotic for OCD...? » morganator, posted by Phidippus on May 20, 2010, at 10:43:09
> > Are you just using an atypical for OCD?
>
> The APA recommends augmenting anti-depressant treatment with an atypical antipsychotic.
>>
> P
Where did you see that recommendation? What is on a website?
Posted by Phidippus on May 22, 2010, at 19:50:14
In reply to Re: The best atypical antipsychotic for OCD...? » Phidippus, posted by Bob on May 21, 2010, at 19:57:07
http://www.psychiatryonline.com/popup.aspx?aID=149623
P
Posted by Bob on May 22, 2010, at 23:34:32
In reply to Re: The best atypical antipsychotic for OCD...? » Bob, posted by Phidippus on May 22, 2010, at 19:50:14
Thanks.
Posted by Brainbeard on May 23, 2010, at 15:17:35
In reply to The best atypical antipsychotic for OCD...?, posted by Phidippus on May 19, 2010, at 18:03:39
It's common practice to augment SSRI's with an antipsychotic, usually atypical, for OCD. Risperidone can really make a difference; the results for quetiapine (Seroquel) are very meagre to my knowledge. I tried Risperdal as monotherapy, low dose, but it wasn't very effective for my OCD. Olanzapine (Zyprexa) is probably the most effective AAP for OCD, but its side-effects have always scared me away.
I'm currently taking flupentixol (also spelled 'flupenthixol'), a typical antipsychotic with an atypical profile, and its anxiolytic properties have been rather impressive.
Still, OCD will conquer most meds in the end, I'm afraid.
Posted by Bob on May 23, 2010, at 18:21:59
In reply to Zyprexa, probably. And what about flupentixol?, posted by Brainbeard on May 23, 2010, at 15:17:35
> It's common practice to augment SSRI's with an antipsychotic, usually atypical, for OCD. Risperidone can really make a difference; the results for quetiapine (Seroquel) are very meagre to my knowledge. I tried Risperdal as monotherapy, low dose, but it wasn't very effective for my OCD. Olanzapine (Zyprexa) is probably the most effective AAP for OCD, but its side-effects have always scared me away.
>What kind of dose levels are indicated for augmentation with olanzapine or risperidone to help with OCD? I would assume it's less than that for treatment of psychosis?
Augmentation of AD's with AAP'sys has always intrigued me a bit since it would logically seem to me that blockade of dopamine activity would tend to depress someone. I guess at lower doses they don't act the same way though.
> I'm currently taking flupentixol (also spelled 'flupenthixol'), a typical antipsychotic with an atypical profile, and its anxiolytic properties have been rather impressive.
>
> Still, OCD will conquer most meds in the end, I'm afraid.
Posted by Brainbeard on May 24, 2010, at 3:19:49
In reply to Re: Zyprexa, probably. And what about flupentixol? » Brainbeard, posted by Bob on May 23, 2010, at 18:21:59
Lower doses are used.
Oddly, combining an SSRI with a low dose dopamine antagonist increases dopamine release in the prefrontal cortex of rats: http://www.nature.com/npp/journal/v30/n1/abs/1300567a.html
Posted by Dinah on May 26, 2010, at 1:36:31
In reply to Re: The best atypical antipsychotic for OCD...?, posted by morganator on May 20, 2010, at 1:13:26
What's helped me most is Risperdal and some variant on cognitive behavior therapy.
I can't say I don't still check some under stress. But it's much more under control, and rarely interrupts my life in a serious way though it can be a nuisance.
I would say that the benefits of the SSRI I took for a few years didn't outweigh the side effects, but I think it's possible they let me get a firm grasp on the therapy.
Posted by Brainbeard on May 26, 2010, at 4:35:54
In reply to Re: The best atypical antipsychotic for OCD...?, posted by Dinah on May 26, 2010, at 1:36:31
> What's helped me most is Risperdal and some variant on cognitive behavior therapy.
>
> I can't say I don't still check some under stress. But it's much more under control, and rarely interrupts my life in a serious way though it can be a nuisance.
>
> I would say that the benefits of the SSRI I took for a few years didn't outweigh the side effects, but I think it's possible they let me get a firm grasp on the therapy.
Did you also combine the Risperdal with the SSRI? Some people get rave results with such a combo, although it can boost prolactin levels through the roof..
Posted by chujoe on May 26, 2010, at 6:17:15
In reply to Re: The best atypical antipsychotic for OCD...?, posted by Brainbeard on May 26, 2010, at 4:35:54
>I think it's possible they let me get a firm grasp on the therapy.<
I think that's what most psych drugs do -- they work best when the person taking them uses them as a stable floor to stand on & then works on psychological issues.
Posted by Bob on May 26, 2010, at 12:24:43
In reply to Re: The best atypical antipsychotic for OCD...?, posted by Brainbeard on May 26, 2010, at 4:35:54
What happens when prolactin levels get overboosted?
Posted by Brainbeard on May 26, 2010, at 14:43:11
In reply to Re: The best atypical antipsychotic for OCD...? » Brainbeard, posted by Bob on May 26, 2010, at 12:24:43
> What happens when prolactin levels get overboosted?
Libido gets suppressed. Men can develop 'man-boobs' (gynecomastia). Women can have their menstruation suppressed. Tumor growth can be promoted. Bones can become brittle.
Posted by Bob on May 26, 2010, at 19:04:23
In reply to Effects And Risks Of A Prolactin Boost, posted by Brainbeard on May 26, 2010, at 14:43:11
> > What happens when prolactin levels get overboosted?
>
> Libido gets suppressed. Men can develop 'man-boobs' (gynecomastia). Women can have their menstruation suppressed. Tumor growth can be promoted. Bones can become brittle.
>
>Wow, that sucks. Is there any way to fight high prolactin?
Do high prolactin levels have anything to do with diabetes risk?
Posted by Brainbeard on May 27, 2010, at 11:58:41
In reply to Re: Effects And Risks Of A Prolactin Boost » Brainbeard, posted by Bob on May 26, 2010, at 19:04:23
>
> Wow, that sucks. Is there any way to fight high prolactin?
>
> Do high prolactin levels have anything to do with diabetes risk?
>
>
I wouldn't know about the diabetes connection. You'd better google that.Yes, there are ways to fight hyperprolactinemia. There are drugs who decrease prolactin levels. Dopamine agonists do, but the ergot derived ones have problems of their own - they can cause cardiac valve trouble. I think quinagolide may be a good non-ergot anti-prolactin med.
Then there is aripiprazole, also known as Abilify, which can also counter drug induced hyperprolactinemia.
This is the end of the thread.
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