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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by ace on October 29, 2009, at 2:39:22
Anyone used either of these agents for OCD?
can you please let me know results...
I am off Seroquel now, but need a low dose atypical AP for my OCD...
Cheers!!!!!!!!!!!!!!
Ace:)
Posted by Phidippus on October 29, 2009, at 3:23:26
In reply to Geoden or Risperidone for OCD???, posted by ace on October 29, 2009, at 2:39:22
I used Invega which is the metabolite of Risperidone. It just put me to sleep. Go for Geodon, it antagonizies 5ht1a receptors which in turn modulate AMPARs which are key in treating OCD. I do 80 mg in a split dose each day.
P
Posted by Phillipa on October 29, 2009, at 10:46:03
In reply to Re: Geoden or Risperidone for OCD???, posted by Phidippus on October 29, 2009, at 3:23:26
How do atypicals help OCD? They have luvox and amityriptalline. Isn't it an anxiety disorder? Phillipa
Posted by delna on October 29, 2009, at 12:36:23
In reply to Geoden or Risperidone for OCD???, posted by ace on October 29, 2009, at 2:39:22
hi,
Honestly, Geodon did nothing for my OCD at all. I know it has some effect on serotonin etc but it didn't help my OCD. But then I have never taken an AP especially for OCD.
My OCD, although really bad, luckily responds to SSRI/SNRI's.
Tc
D
Posted by SLS on October 29, 2009, at 14:43:26
In reply to Re: Geoden or Risperidone for OCD???, posted by Phidippus on October 29, 2009, at 3:23:26
Hi.
I was under the impression that Geodon was a partial agonist at 5-HT1a receptors. However, it might act this way only at somato-dendritic autoreceptors. Where does it act as a full antagonist?
Historically, I think more work has been dedicated to investigating the efficacy of Risperdal for OCD. However, Geodon does inhibit the reuptake of serotonin, so perhaps this would be important in any anti-obsessional properties it might possess.
- Scott
Posted by Phidippus on October 29, 2009, at 19:12:54
In reply to Re: Geoden or Risperidone for OCD???, posted by Phillipa on October 29, 2009, at 10:46:03
In obsessive compulsive disorder (OCD) transmission of dopamine from the substantia nigra to the basal ganglia and caudate nucleus-putamen (neostriatum) is thought to be increased. Atypical antipsychotics, acting as dopamine antagonists, decrease this dopamine transmission. In the case of Geodon, agonism of the 5HT1A receptor Regulates AMPA Receptor Channels decreasing excessive glutamate in the PFC-increased glutamate in the PFC is implicated in OCD.
P
Posted by psychobot5000 on October 29, 2009, at 19:17:02
In reply to Re: Geoden or Risperidone for OCD???, posted by Phidippus on October 29, 2009, at 19:12:54
> In obsessive compulsive disorder (OCD) transmission of dopamine from the substantia nigra to the basal ganglia and caudate nucleus-putamen (neostriatum) is thought to be increased. Atypical antipsychotics, acting as dopamine antagonists, decrease this dopamine transmission. In the case of Geodon, agonism of the 5HT1A receptor Regulates AMPA Receptor Channels decreasing excessive glutamate in the PFC-increased glutamate in the PFC is implicated in OCD.
>
> PAlso of note for Geodon: it blocks 5ht2c receptors, which can worsen OCD. But don't panic; there is a solution: take only a small dose. At 20mg per day, divided into two doses (you have to split up the smallest capsule), 5ht2c antagonism is probably minimal. In any case, I take Geodon in this manner, partly for OCD, and believe I get a mild benefit out of it. 20mg per day. If I go up, it's not helpful, however.
Best,
Psychbot
Posted by Phidippus on October 29, 2009, at 19:18:25
In reply to Re: Geoden or Risperidone for OCD???, posted by SLS on October 29, 2009, at 14:43:26
Serotonin 5-HT1A Receptors Regulate AMPA Receptor Channels through Inhibiting Ca2+/Calmodulin-dependent Kinase II in Prefrontal Cortical Pyramidal Neurons. Seratonin suppresses glutamatergic signaling through the inhibition of CaMKII, which is achieved by the inhibition of PKA and ensuing activation of PP1. Excessive glutamatergic output in the PFC is implicated in OCD.
Posted by Phidippus on October 29, 2009, at 19:20:11
In reply to Re: Geoden or Risperidone for OCD???, posted by SLS on October 29, 2009, at 14:43:26
Scott,
Ziprasidone functiones as an antagonist at the D2, 5HT2A, and 5HT1D receptors, and as an agonist at the 5HT1A receptor.
P
Posted by willyeee on October 30, 2009, at 1:14:33
In reply to Geoden or Risperidone for OCD???, posted by ace on October 29, 2009, at 2:39:22
Be careful with Geodon,thats some potent stuff my man.
Posted by SLS on October 30, 2009, at 6:27:54
In reply to Geoden or Risperidone for OCD???, posted by ace on October 29, 2009, at 2:39:22
> Anyone used either of these agents for OCD?
>
> can you please let me know results...
>
> I am off Seroquel now, but need a low dose atypical AP for my OCD...
>
> Cheers!!!!!!!!!!!!!!
>
> Ace:)You should consider that combining an MAOI with Geodon might produce a hyperserotonergic state. I have never seen them combined, so I think you should proceed cautiously.
- Scott
Posted by SLS on October 30, 2009, at 6:28:34
In reply to Re: Geoden or Risperidone for OCD??? » SLS, posted by Phidippus on October 29, 2009, at 19:20:11
> Scott,
>
> Ziprasidone functiones as an antagonist at the D2, 5HT2A, and 5HT1D receptors, and as an agonist at the 5HT1A receptor.
>
> P
Thanks.:-)
- Scott
Posted by Brainbeard on October 30, 2009, at 13:20:51
In reply to Re: Geoden or Risperidone for OCD??? » Phidippus, posted by SLS on October 30, 2009, at 6:28:34
Risperidone and ziprasidon are both highly potent 5HT2A-antagonists.
Ziprasidon (Geodon), known working mechanisms aside, is known to cause akathisia, i.e. anxious inner restlessness, for many, including yours truly. I took it low dose (10-40mg) and it helped with mood, sleep and sex, but only worsened my anxiety.
By the way, 5HT2C-antagonism is actually (supposed to be) an anxiolytic mechanism, just as 5HT2A-antagonism. Agomelatine, Servier's new AD, is also a 5HT2C-antagonist and has anxiolytic properties.
Posted by ace on October 31, 2009, at 0:09:30
In reply to Re: Geoden or Risperidone for OCD???, posted by Phidippus on October 29, 2009, at 19:12:54
> In obsessive compulsive disorder (OCD) transmission of dopamine from the substantia nigra to the basal ganglia and caudate nucleus-putamen (neostriatum) is thought to be increased.
Keeping with the literature I have read I feel this is highly plausibe. (however this hypothesis would suggest OCD to abate as one gets older- I have seen no evidence of this) To this day, I am still astounded by the overwhelming focus on 5HT in OCD- and anxiety- and depression- and just about every other psychopathology!
Atypical antipsychotics, acting as dopamine antagonists, decrease this dopamine transmission. In the case of Geodon, agonism of the 5HT1A receptor Regulates AMPA Receptor Channels decreasing excessive glutamate in the PFC-increased glutamate in the PFC is implicated in OCD.
>
> PI assume you have seen good results with the agent?
Warm regards,
Ace:)
Posted by ace on October 31, 2009, at 0:11:03
In reply to Re: Geoden or Risperidone for OCD??? » ace, posted by delna on October 29, 2009, at 12:36:23
> hi,
> Honestly, Geodon did nothing for my OCD at all. I know it has some effect on serotonin etc but it didn't help my OCD. But then I have never taken an AP especially for OCD.
did you have many s/effects?> My OCD, although really bad, luckily responds to SSRI/SNRI's.
> Tc
> Dwhat SSRI/SNRI you use? To what extent does it ameliorate your symptoms?
Thanks!
Ace:)
Posted by ace on October 31, 2009, at 0:13:03
In reply to Re: Geoden or Risperidone for OCD???, posted by psychobot5000 on October 29, 2009, at 19:17:02
>
> Also of note for Geodon: it blocks 5ht2c receptors, which can worsen OCD.Yes- and also increase depression. Have you heard much theory about the mechanism behind this? Always low dose AP for me.
But don't panic; there is a solution: take only a small dose. At 20mg per day, divided into two doses (you have to split up the smallest capsule), 5ht2c antagonism is probably minimal. In any case, I take Geodon in this manner, partly for OCD, and believe I get a mild benefit out of it. 20mg per day. If I go up, it's not helpful, however.
Have you tried other AP's...or Clomipramine?
Thanks friend:)
Ace
>
> Best,
> Psychbot
>
Posted by ace on October 31, 2009, at 0:14:15
In reply to Re: Geoden or Risperidone for OCD???, posted by willyeee on October 30, 2009, at 1:14:33
> Be careful with Geodon,thats some potent stuff my man.
In what respect? It seems to be less problematic than Risperidone....and possibly as efficacious...
wish me luck!
thanks mate!
Ace:)
Posted by ace on October 31, 2009, at 0:16:03
In reply to Re: Geoden or Risperidone for OCD??? » ace, posted by SLS on October 30, 2009, at 6:27:54
> > Anyone used either of these agents for OCD?
> >
> > can you please let me know results...
> >
> > I am off Seroquel now, but need a low dose atypical AP for my OCD...
> >
> > Cheers!!!!!!!!!!!!!!
> >
> > Ace:)
>
>
>
> You should consider that combining an MAOI with Geodon might produce a hyperserotonergic state. I have never seen them combined, so I think you should proceed cautiously.
>
>
> - Scott
>Thanks Scott, I will proceed with great caution, with a maximun dose of 20mg I think.
Wish me luck mate:)
Ace
Posted by bulldog2 on October 31, 2009, at 10:43:04
In reply to Geoden or Risperidone for OCD???, posted by ace on October 29, 2009, at 2:39:22
> Anyone used either of these agents for OCD?
>
> can you please let me know results...
>
> I am off Seroquel now, but need a low dose atypical AP for my OCD...
>
> Cheers!!!!!!!!!!!!!!
>
> Ace:)Perhaps zyprexa?
Posted by Phidippus on October 31, 2009, at 18:49:00
In reply to Re: Geoden or Risperidone for OCD??? » Phidippus, posted by ace on October 31, 2009, at 0:09:30
> I assume you have seen good results with the agent?I'm having good luck with it in a low dose. It seems to calm down my anxiety and helps me keep thinking straight through panic a dissociative crap. It also helps me with epileptic nonsense that fouls my brain on occasion. I also get a mood uplift with it.
P
Dexedrin 45 mg
Geodon 80 mg
Keppra 1000 mg
Lexapro 20 mg
Gabitril prn
Tramadol prn
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