Psycho-Babble Medication | about biological treatments | Framed
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Posted by Zeke on December 13, 1999, at 9:49:10

In reply to Inositol, Part II, posted by Adam on December 9, 1999, at 1:20:33

Adam --

Several ideas/questions.

The one obvious thing to me is that you're in a study and your OCD is flaring up. Is this a drug study? If so, its likely double-blind and you don't know if you're on the active drug or not. If you are blindly in the placebo phase, it should not be surprising that symptoms would recur.

I think that even if you're on a high dose of selegiline and thus non-selective MAO inhibition, that augmenting other 5-HT active meds should be a RELATIVE contraindication, not an absolute one. Cautious addition of such a drug should at least be considered.

On the other hand, there's another path that will likewise drive your psychiatrists nuts. In place of Eldepryl, tramadol(Ultram) might be considered as it has efficacy in OCD and possibly affective disorders. The catch is that it acts on the mu-opioid system as well as 5HT. It is a analgesic by indication but isn't a controlled substance. You might look over at Dr. Bob's psychopharm tips for more about it. One issue is that it may (or may not) produce tolerance in re OCD. To move further down this path, if Eldepryl helps but you face these roadblocks, what about an amphetamine? This should improve mood and possibly OCD symptoms, and would be reasonable if Eldepryl -- an amphetamine congener -- helped.

I'm not well versed on the inositol issue. However, if it precipitates insulin release, that's a good reason to suppose it will increase central 5HT by virtue of increased tryptophan levels in the brain. That by virtue of decreasing competing amino acids for entry.




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