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Re: How I feel on high-dose SSRIs

Posted by Dave001 on August 27, 2005, at 19:27:09

In reply to How I feel on high-dose SSRIs » Declan, posted by ed_uk on August 23, 2005, at 15:53:37


> I feel calmer and suffer less intrusive/unwanted thoughts ie. OCD
> obsessions.
>
> I don't tend to worry about the future on SSRIs, my immediate needs
> seem more important.

[...]

Out of curiosity, would you say that your obsessive thoughts are
composed of a lot of "intrusive imagery"?

I wonder how often symptoms that are attributed to the obsessional
component of OCD are really neurobiologically similar to those which are
seen in its classical form. It's an important question, because there
seems to be a dogma that SSRIs and antidopaminergic agents are
necessarily beneficial, when that may be true for only a subset of
patients. Perhaps the opposite approach would work better for others.

The animal models used to study OCD are inadequate. I don't think
there's any good evidence that the stereotypical behaviors seen in
animals have much if anything to do with obsessive thinking. There's a
paucity of data to suggest that a visual component (i.e., thoughts with
imagery) may be a distinguishing feature of OCD, thus making it seem
somewhat similar to schizophrenia. Without any such distinction,
excessive worriers (e.g., GAD) could be lumped into that category as well.

It'd be interesting to see more neuroimaging studies to see whether
obsessional thinking has anything in common with "true" OCD. So-called
ADD/ADHD is often contrasted with OCD, yet the frequent overlap in
diagnoses make me wonder how many people are being treated with drugs
that may have an almost OPPOSITE action from what might help them best.
SSRIs are given for just about everything, so it doesn't necessarily
mean much when successful treatment of a given symptom complex is
ascribed to them. When amphetamine first became popular, it was also
"successfully" used to treat every imaginable condition.

The problem with all of these so-called disorders is that they're just
symptom complexes that are probably heterogeneous in origin, and thus
using up the limited space remaining for new acronymical designations.


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URL: http://www.dr-bob.org/babble/20050827/msgs/547355.html