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Re: Information please, anorexic OCD 13yr old

Posted by linkadge on May 27, 2006, at 17:56:03

In reply to Re: Information please, anorexic OCD 13yr old » linkadge, posted by Racer on May 27, 2006, at 17:04:46

>Link, while it's true that SSRIs can cause GI >problems, and might even reduce appetite, >they're often helpful after other treatments >have restored weight. After two years of >residential treatment, one would hope that this >girl's weight is at least partially restored.

Anorexia is a documented side effect of some of the newer antidepressants. While anorexia may fall in the OCD spectrum, and while SSRI's may help some emotional symtpoms, they have not proven consistently effective in changing the anorexic mindset.

The problem with SSRI's is that an increase of serotonin in the hypothalamus leads to a decrease in food consumption, while a decrease in serotonin is related to an increase in food intake. Cyproheptadine (periactin) a serotonin antagonist, has been used sucessfully in some cases of anorexia.

>Nope, TCAs are contraindicated in AN. Their >cardiotoxicity is too dangerous. AN often >weakens the heart, sometimes leading to sudden >death. Adding a TCA to that isn't a great idea.

I have heard of cases of anorexia which responded to amitryptaline or remeron, but not SSRIs. Amitryptaline has serotonin antagonist properties which is not shared by the SSRI's.

If after rehabilitation, the heart is in a more healthy state, you may need to ask yourself which medication would be more effective for the OCD. While TCA's are often more effective for bulimia, certain such as elavil or anafranil can sometime be more effective than SSRI's when comorbid depression / OCD is present.

Linkadge



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poster:linkadge thread:649289
URL: http://www.dr-bob.org/babble/20060525/msgs/649447.html