Posted by yxibow on May 3, 2009, at 0:54:35
In reply to Re: OCD - Just a thought. » yxibow, posted by SLS on May 2, 2009, at 7:20:18
> Recent research seems to be focusing on the evolution of hyperactive dopaminergic circuitry loops in the basal ganglia (cortico-striato-thalamic) that are allowed to occur due to a deficit of serotonergic modulation afferent from the raphe nuclei. There appears to be no interest in the locus coeruleus or noradrenergic pathways.
>
> Do neuroleptics help at all?
>
>
> - Scott
I don't know if Seroquel is only offlabel helping the dopamine imbalance which has no etiology and is one of the main sources of something I've never encountered before.From evidence based psychiatry (what seems to have worked), the theory that D2 or even other things have been dampened is particularly obvious.
I think it has been obvious in two particular forms of OCD -- one, the less than 1% where the patient with OCD is not aware at all that their compulsions are out of balance and there is a psychosis component to it, and two, treatment resistant OCD, especially things like "Pure O" which remain a very hard thing to fight.
So yes, judicious and sparing augmentation with low potency neuroleptics have helped people in these situations -- and the MED (minimum effective dose) should definitely be followed because people with affective disorders have higher sequelae to neuroleptics than people with pure psychotic disorders.
I'm not sure that I would use Risperdal, it has basically been one of the only atypicals that has a known record of TD, but on the other hand there are some people who respond best to it.More likely I would wee a scenario with less "jumpy" SSRIS than Prozac and a combination with say Seroquel, Zyprexa, Abilify, even Clozaril although I would imagine that would be extremely exotic.
-- Jay
poster:yxibow
thread:893777
URL: http://www.dr-bob.org/babble/20090426/msgs/893978.html