# Meds for OCD?



## CopadoMexicano (Aug 21, 2004)

Anyone know a med that can help with symptoms of ocd? Ive read that AD's are treatment resistant but dont know if its true. Ive tried zoloft and lexapro but didnt help.


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## meyaj (Sep 5, 2009)

Serotonergic TCAs can be quite effective. Therapy is also quite important in OCD.


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## BearFan (Mar 22, 2008)

Usually for reduction in OCD symptoms, it takes longer and slightly higher dosages. All SSRIs should help it somewhat. Prozac is approved for management of OCD as well.


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## UltraShy (Nov 8, 2003)

I've never found any drug that reduced my OCD. Well, I guess alcohol does, but only because it's hard to obsess when you're a bit intoxicated and don't really give a damn about anything at that time.


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## Vini Vidi Vici (Jul 4, 2009)

MavenMI6Agent009 said:


> Anyone know a med that can help with symptoms of ocd? Ive read that AD's are treatment resistant but dont know if its true. Ive tried zoloft and lexapro but didnt help.


a large portion of OCD sufferers wont get any benefit (or only a small one) from SSRIs.... meds that lower Glutamate activity, or block NMDA receptors (which glutamate activates) can help alot,....Memantine, an NMDA antagonist, has helped my OCD significantly, especially since im also taking Dexedrine right now, which would normally worsen my OCD, the memantine has prevented my OCD from getting terrible. Riluzole, which lowers glutamate activity, has been shown to help alot with OCD, Depression, and Also Anxiety. You could try Neurontin or Pregabalin (Lyrica} they inhibit glutamate release, and have helped some people. Chronic (extended) nicotine use/treatment can help with OCD, it certainly always decreases my OCD.

the most viable/accessible option is probably Memantine, since it can be purchased relatively cheaply online, but its expensive if you get it in the U.S.

Nicotine is easy to do, from my experiences, Nicotine gum has helped me the most in reducing OCD symptoms, and it also has none of the risks associated with Tobacco use. make sure, if u try nicotine gum, to NOT get one with Aspartame. Aspartame can theoretically worsen OCD symptoms, depending on how much is consumed..small amounts might not make a difference, but a couple grams of it would likely cause increased symptoms.

Opiates can kill OCD, but opiates carry too much baggage to be prescribed for off label uses.....the only viable ones one could use would be Tramadol and Codeine. Both have distinct mechanisms, apart from all the opiates, which make them theoretically more useful at lower dosages for OCD.

Tramadol cant be taken with SSRIs, or pretty much any Serotonergic Med.....so Codeine is a better choice, although when taken with some SSRI/SNRIs, it wouldnt be as effectively metabolised, and it wouldnt work as well.

a combination of SSRI+NMDA antagonist+Opiate might show much higher remission rates for OCD patients. (maybe)


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## Neptunus (Oct 29, 2007)

I've heard paxil is good for OCD. Despite my sensitivity to it, it's helped mine.


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## UltraShy (Nov 8, 2003)

Neptunus said:


> I've heard paxil is good for OCD. Despite my sensitivity to it, it's helped mine.


First mental health drug I ever tried was Paxil. All it did was prevent orgasms and make me sweat a lot. I wasn't impressed.


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## UltraShy (Nov 8, 2003)

Vini Vidi Vici said:


> Opiates can kill OCD, but opiates carry too much baggage to be prescribed for off label uses.....the only viable ones one could use would be Tramadol and Codeine. Both have distinct mechanisms, apart from all the opiates, which make them theoretically more useful at lower dosages for OCD.


Tramadol (Ultram) doesn't do anything for me and I've certainly tried enough to know.

And I'll let my OCD shine, by pointing out that you should technically say opioid.

Opiate: morphine and others naturally found in opium

Opioid: broader term; includes all opiates plus semi-synthetic (such as oxycodone), and synthetic (such as methadone).

I'd also argue that tramadol isn't an opioid. It does have weak opioid activity, so the issue can be debated, but I think it's on par with calling a water pistol a weapon.


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## Neptunus (Oct 29, 2007)

UltraShy said:


> First mental health drug I ever tried was Paxil. All it did was prevent orgasms and make me sweat a lot. I wasn't impressed.


Yep, I've experienced both. Lesser of two evils as far as I'm concerned.


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## meyaj (Sep 5, 2009)

rocknroll714 said:


> Psychedelics including LSD, psilocybin, and mescaline, among others, completely alleviate the symptoms of OCD for their duration. There are a few reports of people self-medicating with them. Notably, it's supposedly said that while tolerance occurs to their psychotropic effects, it doesn't occur to their positive effects on OCD. Hence, with chronic dosing, after the first few days there should no longer be psychedelia, and instead only OCD relief.


Psychedelics can also make it much, much, worse. I had a bad shroom trip where I couldn't stop freaking out about getting the dishes clean, and it was made even worse by the whole fact that when you're tripping that hard, it's impossible to tell whether or not the dishes I was cleaning were, in fact, clean. Man it was a nightmare...

I'd really have a difficult time recommending that to people with OCD.


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## crayzyMed (Nov 2, 2006)

meyaj said:


> Psychedelics can also make it much, much, worse. I had a bad shroom trip where I couldn't stop freaking out about getting the dishes clean, and it was made even worse by the whole fact that when you're tripping that hard, it's impossible to tell whether or not the dishes I was cleaning were, in fact, clean. Man it was a nightmare...
> 
> I'd really have a difficult time recommending that to people with OCD.


LSD made my OCD significantly better, the trip itself was horrible tough and it was the most terrible experience of my life, but the aftereffects were good, lasting for allmost 2 years allready now.

But psychedelics can also be taken in treshold doses, in those doses you wont trip, you will only notice an antidepressant effect. This is very experimental tough.

Anyway, those are the receptors involved in OCD.



> The activity of certain receptors is positively correlated to the severity of OCD, whereas the activity of certain other receptors is negatively correlated to the severity of OCD. Correlations where activity is positively correlated to severity include the histamine receptor (H2); the Muscarinic acetylcholine receptor(M4); the Tachykinin receptor (NK1); and non-NMDA glutamate receptors. Correlations where activity is negatively correlated to severity include the NMDA receptor (NMDA); the Mu opioid receptor (μ opioid); and two types of 5-HT receptors (5-HT1D and 5-HT2C) The central dysfunction[clarification needed] of OCD may involve the receptors nk1, non-NMDA glutamate receptors, and NMDA, whereas the other receptors could simply exert secondary modulatory effects.


http://en.wikipedia.org/wiki/Biology_of_obsessive–compulsive_disorder

5-HT1Dβ · /

5-HT2A · Psychedelics

5-HT2C · Agomelatine

μ Opioid · Opiates, tramadol, buprenorphine

H2 · Histamin antagonists, i'm not sure which ones can cross the blood brain barrier tough

NK1 · Aprepitant

M4 · /

NMDA · Memantine, N acetyl cysteine.

non-NMDA - Riluzole, acamprosate maybe (ive got that in a few weeks, its a differend kind of glutamate antagonist that doesnt work on NMDA, and may be beneficial for OCD).


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## mark555666 (May 1, 2008)

I always believed that OCD was mostly a serotonin issue. 
High doses of ssri's and benzo's work the best imo.


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## Ehsan (Mar 21, 2009)

as far as i know Anfranil is indicated and highly used for OCD.
i've never had OCD and only use it for SAD.
last week i quit anfranil to try a new med but now i feel a little ocd!


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## Vini Vidi Vici (Jul 4, 2009)

Freesix88 said:


> I always believed that OCD was mostly a serotonin issue.
> High doses of ssri's and benzo's work the best imo.


High doses of SSRIs, and Benzos, pretty much act like a Gigantic brake on the brain...they are almost not really fixing the problem, as much as simply smothering it so that it isnt as noticable. Paxil, and other SSRIs, decreased my GAD, and SA quite effectively. They decreased my depression in a variable manner, sometimes working, but most times not working. But with my OCD, i only noticed a decrease in the mental anquish it causes.....i still had all my OCD characteristics and tendencies, even when on high doses of SSRIs and Benzos.


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## crayzyMed (Nov 2, 2006)

Amphetamine completely ABOLISHED my OCD, for me amphetamine is the most effective treatment.

I just found out that ppl with OCD appear to have low D2 binding.


> Striatal dopamine D(2) receptor availability in OCD with and without comorbid social anxiety disorder: preliminary findings.
> Schneier FR, Martinez D, Abi-Dargham A, Zea-Ponce Y, Simpson HB, Liebowitz MR, Laruelle M.
> 
> Anxiety Disorders Clinic, New York State Psychiatric Institute, New York, NY 10032, USA. [email protected]
> Dopamine D(2) receptor availability in the striatum has been reported to be low in generalized social anxiety disorder (GSAD) and obsessive-compulsive disorder (OCD), but it has not been studied in persons with comorbid OCD and GSAD (OCD+GSAD). D(2) receptor availability was assessed in 7 subjects with OCD+GSAD, 8 with OCD, and 7 matched healthy comparison (HC) subjects, all unmedicated adults. D(2) receptor availability was assessed with single-photon emission computerized tomography (SPECT) to measure binding potential (BP) of the D(2) receptor radiotracer [(123)I] iodobenzamide ([(123)I]IBZM). Mean striatal [(123)I]IBZM BP was significantly lower in the OCD+GSAD group (72.58 mL/g, SD=18.17) than in the HC group (118.41 mL/g, SD=45.40; P=.025). Mean BP in the OCD group (93.08 mL/g, SD=36.90) did not differ significantly from the HC group (P=.247). Trait detachment, as measured by the Detachment subscale of the Karolinska Scales of Personality, was negatively correlated with D(2) availability across all subjects (r(s)= -.55, P=.013). Comorbid GSAD and OCD may be associated with decreased availability of D(2) receptors in the striatum, consistent with prior findings in GSAD. Prior findings of decreased D(2) receptor availability in noncomorbid OCD were not confirmed. Decreased D(2) receptor availability was also associated with trait detachment, supporting prior findings in samples of healthy subjects.





> Low level of dopaminergic D2 receptor binding in obsessive-compulsive disorder.
> Denys D, van der Wee N, Janssen J, De Geus F, Westenberg HG.
> 
> Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.
> BACKGROUND: Despite growing evidence for involvement of the dopaminergic system in obsessive-compulsive disorder (OCD), the functional anatomy of the dopaminergic system in the basal ganglia has been investigated sparsely. METHODS: Dopamine D(2) receptor binding was assessed in 10 medication-free OCD patients and 10 healthy control subjects, matched for age, gender, and handedness. The binding potential was measured with single photon emission computerized tomography (SPECT) and infusion of the D(2) receptor radiotracer [(123)I] iodobenzamide. With magnetic resonance imaging as reference, regions of interest (caudate and putamen) were delineated for each hemisphere and coregistered with the corresponding SPECT scans. RESULTS: Dopamine D(2) receptor binding in the left caudate nucleus was significantly lower in the patients with OCD than in healthy control subjects [F(1,18) = 7.0, p =.016]. In addition, an interhemispheric difference was observed in the patient sample. Both the D(2) receptor binding potential (df = 9, p =.012), and the volume (df = 9, p =.029) of the left caudate nucleus were statistically significantly reduced relative to the right caudate nucleus. CONCLUSIONS: This study provides in vivo evidence for abnormalities in the binding potential of the dopamine D(2) receptor, which suggest the direct involvement of the dopaminergic system in the pathophysiology of OCD.


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## Vini Vidi Vici (Jul 4, 2009)

what does "low D2 binding" mean? does it mean that there is simply a deficit in D2 receptors? or could it be a result of overactive dopamine activity, subsequently downregulating the D2 receptors.... if a D2-binding ligand is being used to measure the number of D2 receptors, then wouldnt Dopamine be competing with the ligand for D2 occupancy? how does one know if the ligand, or dopamine, has a higher affinity for D2 receptors? the affinity could be estimated, but not precisely determined. this has always confused me

but, D2/3 agonists induce OCD-like behaviors in rats, and in humans. D2/3 probably has different effects in brain areas other than the caudate nucleus


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## Vini Vidi Vici (Jul 4, 2009)

crayzyMed said:


> Amphetamine completely ABOLISHED my OCD, for me amphetamine is the most effective treatment.


amphetamine, at first, also significantly decreased my OCD. however, is it actually correcting pre-existing imbalances which cause OCD, or is it just masking the OCD? ive noticed that amphetamine enables me to bypass some of my OCD behaviors/actions,....it doesnt eliminate them, it is just easier to bypass them. it seems like maybe the increased dopamine is able to somewhat mask the discomfort caused by avoiding compulsions (like washing my hands) where normally avoiding compulsions causes immediate anxiety/depression, with amphetamine, i dont feel as bad when i avoid washing my hands.

how long did you use amphetamine/it helped with the OCD? even when my OCD is really bad, Amphetamine still helps me to bypass the OCD...it doesnt seem to abolish it, it just smooths it out, helping me to concentrate on what i want to concentrate on, as opposed to worring about random other stuff.


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## crayzyMed (Nov 2, 2006)

It means that the dopamine receptors are downregulated, its possible that there is too much dopamine but i doubt it as amphetamine reduces my OCD (or my brain may be differend )

I'm guessing that dopamine agonists hit more brain regio's as they arent dependent on regio's with alot of the dopamine transporter, wich results in agonizing some regio's that are involved with OCD.

This all gueswork tough as i pretty much have no idea on this subject, i just ran acros those abstracts.


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## crayzyMed (Nov 2, 2006)

Vini Vidi Vici said:


> amphetamine, at first, also significantly decreased my OCD. however, is it actually correcting pre-existing imbalances which cause OCD, or is it just masking the OCD? ive noticed that amphetamine enables me to bypass some of my OCD behaviors/actions,....it doesnt eliminate them, it is just easier to bypass them. it seems like maybe the increased dopamine is able to somewhat mask the discomfort caused by avoiding compulsions (like washing my hands) where normally avoiding compulsions causes immediate anxiety/depression, with amphetamine, i dont feel as bad when i avoid washing my hands.
> 
> how long did you use amphetamine/it helped with the OCD? even when my OCD is really bad, Amphetamine still helps me to bypass the OCD...it doesnt seem to abolish it, it just smooths it out, helping me to concentrate on what i want to concentrate on, as opposed to worring about random other stuff.


In my case it doesnt help to ignore the toughts, it just COMPLETELY removes the OCD toughts and normalizes my tought pattern. It definatly does more then mask the symptons.

I used it 2 weeks, but i stopped as i was using street amphetamine and that clearly is no long term solution, i just wanted to know how it worked in low doses.

I also didnt have anything to control tolerance, didnt build any tough, but that would have happened sooner or later.


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