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Re: OCD Dont know where to go

Posted by ed_uk2010 on February 1, 2015, at 8:46:56

In reply to Re: OCD Dont know where to go, posted by Bill82 on January 31, 2015, at 19:05:46

>And while d2 antagonists are effective for tics, I am not sure how helpful they are for ocd, which is my chief complaint

They don't seem too useful for most people with OCD, but a subset do appear to respond. Long term side effects are certainly a major concern. D2 antagonist can potentially be used 'when required' for exacerbations in those who do respond, so that's something to consider. Some people find them useful for acute agitation. Again, you'd need to be cautious with the dose because too much can cause akathisia and more agitation. Those with OCD are generally less tolerant of antipsychotics than people with psychotic disorders. If you were to find something which provided at least partial or temporary relief, do you think you could undergo CBT with benefit?

In terms of the few antipsychotics which cause little or no EPS, have you tried Seroquel? I imagine you'd find it quite sedating but it is worthy of consideration.

What effect, if anything, did Risperdal have on your OCD? I know it wasn't tolerable, but did it affect your OCD?

>I will definitly look into the saffron, from my reading it looks like the extract used in most studies is similar to a component of tylenol, so I'll be weary of liver side effects.

I'm not sure what you mean about it being similar to a component of Tylenol. Studies using 15mg extract twice a day have shown good tolerability. Reported side effects in a minority include headache and nausea. Studies using double this dose (30mg extract twice a day) have shown evidence of decreased haemoglobin levels after long-term treatment. It seems best not to use the higher dose long-term. Of course, some countries use a lot of saffron in food, for colour and flavour, and I've not heard any mention of liver damage. Massive acute overdoses can cause bleeding, but there's no way you'd be taking anything like that much. Adding saffron to SSRIs seems to improve erectile function. On its own, it doesn't have much effect on sexual function... or so it seems.

>Other than that I guess I could talk about pregabalin again, but when I mean I had a problem in benzos and od I mean I took one, became drug seeking, yelled at people, then found them and just kept taking them till I blacked out, so maybe that's why she got scared off.

Pregabalin does have potential for misuse. It doesn't sound ideal for you to be quite honest.

>Other thoughts I had were amantadine, because of both nmda and....

You've tried the related memantine. Amantadine is similar but possibly more dopaminergic. I don't think it's the best choice for you right now.

>riluzole, but not sure it would do anything as monotherapy

It might, but is it affordable? If so, it could be something to try soon. It's generic here and much less expensive than it was. What's the situation with insurance coverage?

>Anyways hope I didn't write too much

Not at all.


I'm unsure whether this drug will be marketed. It might be. It sounds like something which would be used to augment other treatments.


Now that it's little used due to liver issues... have you tried the related vilazodone? You might find vilazodone similar to vortioxetine, but it's difficult to say. Vilazodone binds to fewer receptors. It's mainly a serotonin reuptake inhibitor which also stimulates 5-HT1a receptors. I think it's fairly clear that you experience an unusually high incidence of side effects with serotonin reuptake inhibitors. This may be, in some ways, related to your age. People under 25 appear to experience considerably more psychiatric adverse effects to SRIs than older ppl.

Take care.




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