Psycho-Babble Medication Thread 1409

Shown: posts 1 to 5 of 5. This is the beginning of the thread.

 

Remeron for OCD (includes response to Toby)

Posted by Matt on December 1, 1998, at 3:27:15

I've been told by a reliable source that Remeron is showing promise as a drug for OCD. Has anyone had any experience with this drug for OCD, or has anyone heard anything about Remeron's anti-obsessive powers?
Thanks,
Matt

Toby--you replied that since Remeron increased the level of serotonin in the synapse, it should help with OCD. Serzone does the same thing (though in a different way), but from all I read it does absolutely nothing to help with OCD.

Thanks

Matt

 

Re: Remeron for OCD

Posted by Toby on December 1, 1998, at 15:47:04

In reply to Remeron for OCD (includes response to Toby), posted by Matt on December 1, 1998, at 3:27:15

Indeed you are correct that Serzone does little for OCD... by itself. It is helpful sometimes in treatment resistent OCD when added to an SSRI. It has something to do with a balancing act between the different subtypes of serotonin receptors (of which there are many). Treatment for OCD relies on boosting serotonin far more than norepinephine and generally the doses of SSRI's are much higher for OCD than for depression. Since the higher the dose of Remeron the more norepinephine it boosts, I don't know if that would affect its ability to help OCD; the balancing act may be important here too. So it remains to be seen if Remeron will be helpful for OCD but I still think it may be helpful as an augmenting agent, even if not all by itself, like Serzone.

Thoughts from other docs?

 

Re: Remeron for OCD

Posted by Matt on December 2, 1998, at 0:42:40

In reply to Re: Remeron for OCD , posted by Toby on December 1, 1998, at 15:47:04

> Indeed you are correct that Serzone does little for OCD... by itself. It is helpful sometimes in treatment resistent OCD when added to an SSRI. It has something to do with a balancing act between the different subtypes of serotonin receptors (of which there are many). Treatment for OCD relies on boosting serotonin far more than norepinephine and generally the doses of SSRI's are much higher for OCD than for depression. Since the higher the dose of Remeron the more norepinephine it boosts, I don't know if that would affect its ability to help OCD; the balancing act may be important here too. So it remains to be seen if Remeron will be helpful for OCD but I still think it may be helpful as an augmenting agent, even if not all by itself, like Serzone.
> Thoughts from other docs?

Not a doc, but from what I read and my own experience, mixing SSRIs and Serzone produces bigtime anxiety. I'm surprised to hear that you've mixed the two. Also, I take it you mean that the increase of norepinephrine in the synapse as one ups the dose of Remeron isn't a linear function of the dose of Remeron? From what I understand about Effexor, it is this way too, one gets a nonlinear increase in the amount of norepinephrine as one ups the dose of the drug. Does Effexor look to be less effective for OCD in higher doses, then? Or does the increase in serotonin somehow outweigh this nonlinear increase in norepinephrine?

Matt

 

Re: Remeron for OCD

Posted by Toby on December 3, 1998, at 15:45:38

In reply to Re: Remeron for OCD , posted by Matt on December 2, 1998, at 0:42:40

Good questions, but I have few answers. I know taht Effexor and Remeron and Serzone are being looked at for OCD because no one knows what the "real" mechanism of OCD is. It appears that for many patients with OCD, boosting serotonin directly isn't enough, so other agents are used to indirectly boost it (like using an antipsychotic to increase dopamine or using a benzodiazepine). Other meds that act on serotonin to either increase the levels available in the brain or send more out into the synapses or help to keep it from being broken down are trazodone, buspar, and fenfluramine. Some of these meds work well for some patients, some don't do anything at all. Theoretically, some of the novel new meds may work on serotonin in a unique way or may be using some unique combination of the actions of the meds listed above to help OCD. Anyway, regarding the norepinephrine, I still don't know if that overwhelms the serotonin effects of the Remeron and Effexor at higher doses to the extent that it would help or hurt OCD. Good questions, though. You are making me look stuff up. Hope somebody else knows something that could enlighten us.

 

Re: Remeron for OCD

Posted by Matt on December 5, 1998, at 6:21:30

In reply to Re: Remeron for OCD , posted by Toby on December 3, 1998, at 15:45:38

Toby,

Thanks for the response and the effort in looking things up. I very much appreciate it.

Matt


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