Posted by yxibow on May 1, 2009, at 18:15:59
In reply to OCD - Just a thought., posted by SLS on May 1, 2009, at 18:01:39
> While eating my Raisin Bran earlier, it occurred to me that in OCD there is probably something out of whack in the balance between the locus coeruleus and raphe nuclei - the regional source of norepinephrine (NE) and serotonin (5-HT) respectively. Perhaps this is why clomipramine works so well. It might help to reregulate both pathways simultaneously.
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> Why not combine Prozac, an atypical SSRI with anti-OCD properties, with either desipramine or nortriptyline to treat OCD and avoid the anticholinergic side effects of clomipramine?
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> Just a thought.
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> - ScottWell there was a small study which you may not be able to access
http://ajp.psychiatryonline.org/cgi/content/abstract/154/9/1293
I suppose its sufficiently old that I can post it
"Am J Psychiatry 1997; 154:1293-1295
Copyright © 1997 by American Psychiatric Association
Addition of desipramine to serotonin reuptake inhibitors in treatment- resistant obsessive-compulsive disorderLC Barr, WK Goodman, A Anand, CJ McDougle and LH Price
Clinical Neuroscience Research Unit, Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, USA.OBJECTIVE: The purpose of this study was to determine whether combined treatment with a selective serotonin reuptake inhibitor (SSRI) and a norepinephrine reuptake inhibitor, desipramine, effectively reduces obsessive-compulsive symptoms in patients who do not respond to SSRIs. METHOD: In a double-blind study, desipramine or placebo was added for 6 or 10 weeks to the treatment of 30 patients with obsessive-compulsive disorder whose symptoms were refractory to SSRI treatment (fluvoxamine, fluoxetine, or sertraline) alone. RESULTS: There were no significant differences between the adjunctive desipramine and placebo groups in obsessive-compulsive or depressive symptoms. CONCLUSIONS: These data suggest that clomipramine's possibly superior efficacy in the treatment of obsessive-compulsive symptoms may not stem from its capacity to inhibit reuptake of norepinephrine"
The OCD foundation at the time, btw, was in New Haven CT. Their address now reflects Boston.
Which basically means that at least in this small study your idea, while an interesting posture, showed an insignificant difference with Anafranil.
Personally, though, NE now raises my anxiety level (eventually converted to adrenaline) and so I cant take a higher dose of Anafranil than I already am.But others may react differently
-- Jay
poster:yxibow
thread:893777
URL: http://www.dr-bob.org/babble/20090426/msgs/893779.html