Psycho-Babble Medication | about biological treatments | Framed
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Re: OCD Dont know where to go

Posted by ed_uk2010 on January 31, 2015, at 18:00:27

In reply to Re: OCD Dont know where to go, posted by Bill82 on January 31, 2015, at 16:03:55

>I am currently on nac at 2600mg a day split into two doses so I hope it will help.

Have you just started it? Hope it helps.

>I was about to try pregabalin but p doc decided against it due to adverse reactions to other GABA meds (benzos and lamictal).

Pregabalin isn't at all similar to Lamictal. The fact that they're both used to treat focal epilepsy is essentially where the similarity ends.

Pregabalin has similarities and differences to benzos. Both can produce a 'drunk' feeling in some cases. Both tend to be associated with withdrawal symptoms. But they aren't the same, that's for sure.

>As for tics the best of my recollection is I do not have them off ssris.

RE antipsychotics. Have you ever taken a relatively selective dopamine D2 antagonist such as haloperidol or pimozide? Haloperidol is often poorly tolerated except at very low doses but your response (or lack of response) to this type of drug would potentially give a clue as to the underlying biology of your OCD, which could influence further treatment choices. You would need to be very cautious with the dose to avoid akathisia, if you did try it. Pimozide seems to cause slightly less EPS than haloperidol; it does need a pretreatment EKG and very cautious dose adjustment. Abilify and Risperdal hit so many receptors it's difficult to know what caused what..... As for the antipsychotic Zyprexa, it can sometimes worsen OCD - possibly by blocking serotonin 5-HT6 receptors.

>Occasionally I will get a small one when in public and very stressed, but this is always just a small motor tic of my head, and happens very infrequently when off ssri.

Since you've experienced tics, it might be useful to find out if your OCD responds to tic-suppressing drugs eg. haloperidol, pimozide, and the anti-adrenergics guanfacine and clonidine. OCD associated with tics may be a specific subtype (and poorly responsive to SSRIs), although I recognise that you don't experience many tics in the absence of aggravating medication. In Europe, sulpiride is a dopamine antagonist effective against tics and related behaviours. It's licensed as an antipsychotic and has a low to moderate risk of EPS. It's not available in the US.

Hope this gives you some ideas.




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