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Re: Need to figure out meds to take for SA and OCD Chris2011

Posted by Chairman_MAO on October 13, 2011, at 23:03:45

In reply to Need to figure out meds to take for SA and OCD, posted by Chris2011 on April 21, 2011, at 14:16:44

Time to try something new:


1. J Clin Psychiatry. 2005 Mar;66(3):353-9.

Double-blind treatment with oral morphine in treatment-resistant
obsessive-compulsive disorder.

Koran LM, Aboujaoude E, Bullock KD, Franz B, Gamel N, Elliott M.

Department of Psychiatry and Behavioral Sciences, Stanford University Medical
Center, Stanford, CA 94305, USA. lkoran@stanford.edu

BACKGROUND: Obsessive-compulsive disorder (OCD) often responds inadequately to
serotonin reuptake inhibitors (SRIs). A case series reported substantial response
to once-weekly oral morphine. We conducted a placebo-controlled, double-blind
trial to investigate whether once-weekly oral morphine is effective in
SRI-resistant OCD.
METHOD: Subjects with DSM-IV-defined OCD for > or =3 years who had failed > or =2
adequate SRI trials and had a Yale-Brown Obsessive Compulsive Scale (Y-BOCS)
score of > or =20 were recruited. Current medications were continued. Subjects
were randomly assigned to random-order, 2-week blocks of once-weekly morphine,
lorazepam, and placebo. Week 2 dosage was increased, decreased, or maintained
depending on response and side effects.
RESULTS: We enrolled 23 subjects, who had failed 2 to 6 SRI trials. The median
screening Y-BOCS score was 29. The median Y-BOCS score after morphine (highest
dose) was 25 (median decrease = 13%). Seven subjects (30%) were responders
(Y-BOCS decreases > or =25%). The median Y-BOCS score after lorazepam (highest
dose) was 27 (median decrease = 6%). Four subjects (17%) responded to lorazepam;
1 was a morphine responder. The median Y-BOCS score after placebo (highest dose)
was 27 (median decrease = 7%), and no subject responded. Responses differed
significantly among the 3 conditions (Friedman 2-way analysis of variance,
chir(2) = 13.92, df = 2, p = .01). Wilcoxon matched-pairs signed-rank tests (T =
56.5, p = .05) showed significance for morphine versus placebo but not lorazepam
versus placebo.
CONCLUSION: Our results support the hypothesis that once-weekly oral morphine can
reduce symptoms in some treatment-resistant OCD patients. The mechanism of action
is unknown. Further studies of mu-agonists and glutamate antagonists are
warranted.


PMID: 15766302 [PubMed - indexed for MEDLINE]


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poster:Chairman_MAO thread:983445
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