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Re: Benzodiazepines/OCD

Posted by PaulB on May 22, 2001, at 17:46:23

In reply to Re: Benzodiazepines/OCD PaulB, posted by SalArmy4me on May 22, 2001, at 14:35:56

> GREIST, JOHN H.. JEFFERSON, JAMES W.. Pharmacotherapy for OCD. British Journal of Psychiatry. 173(35S) Supplement:64-70, August 98:
> Because it is usually classified as an anxiety disorder, there would be semantic logic in using an anti-anxiety drug for OCD. A recent review (Hewlett, 1993) summarises positive case reports over many years. Interpretation of these reports is difficult as the distinction between quelling of anxiety and specific anti-OCD effects is not clear, and abnormalities in benzodiazepine receptors have not been identified in people with OCD (Weizman et al, 1993).
> The only controlled trial of a benzodiazepine compared clonidine, clonazepam, clomipramine and diphenhydramine (Hewlett et al, 1992). In this six week crossover design, clonazepam was significnatly more effective at three weeks than nay of the other treatments but plateaued thereafter. Clomipramine evinced a numeric but not statistical superiority that was still increasing when the study concluded at six weeks. Diphenhydramine was as effective as clonazepam at six weeks while clonidine was less effective than the other three treatments. Dropouts because of side-effects were greatest for clonazepam. Interestingly, among benzodiazepines, clonazepam may have unique effects upon serotonin (Hwang & Van Woert, 1979; Pranzatelli, 1989).

There does seem to be talk here of Clonazepam, as having some utility for OCD sufferers but not because of its classical tranquillising properties but because of the fact that a metabolite of Clonazepam is a serotonin agonist. Im not going to go look up its name. For the first few weeks a benzodiazepine seems to be a cure for all that ails thee, so claimed Roche in the early 60s but I dont think they help OCD sufferers much. Any more views on GABA/OCD welcomed?




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