The job of your nerve cells is to send messages back and forth like a telephone wire. These chemicals are sent out by one nerve cell into the space between it and the next. The next cell in line gets the message once those chemicals get to it from across the gap. That nerve cell then releases a chemical toward the next nerve cell so it gets the message. A key gene for this process is hSERT which has the instructions for making a serotonin transporter.
To put it simply, their nerve cells are whispering when they should be speaking out loud. In order to allow the nerve to recover and receive the next message, the body has a clever way of removing the neurotransmitter from the receptors, and allowing it to be taken back into the originating nerve re-uptake. The SSRIs slow down the collection of serotonin by transporters like hSERT and the process of returning the serotonin to the end of the neuron it comes from.
This is thought to mean that serotonin stays in the space between the cells longer and increases the chances that the second cell will get the message. Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of Obsessive-Compulsive Disorder or any other medical condition.
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In more details… The job of your nerve cells is to send messages back and forth like a telephone wire. What to read next: Medications for OCD. Medication Side Effects. Page information and additional reading. Last Checked: 4th July Next Review Due: January Search Submit Clear. About us. Contact us. Direct Debit Make an ongoing monthly, quarterly or annual payment. Online Make a one-off payment. Helpful Links. Join by Direct Debit.
Join by Standing Order. Membership Page. Online Make a one-off donation. Direct Debit Make an ongoing monthly, quarterly or annual donation. Medications that target serotonin pathways in the brain, like antidepressants , are particularly effective in treating people with OCD—and if this doesn't work, adding on an antipsychotic medication may be useful.
Let's take a look at the various medications used to treat OCD, including antidepressants and antipsychotics, that have been found to be effective in scientific studies. Though they're traditionally used to treat depression , research has shown SSRIs to be the most effective medications for OCD, as well.
Anafranil may cause side effects such as dry mouth, blurred vision, sedation, and rapid heartbeat. It can also lead to weight gain. Your doctor will probably start you on a low dose to begin with and increase it if needed.
The following listed dosages are according to American Psychiatric Association recommendations. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.
Most people will experience at least some symptom relief after taking the antidepressants approved for OCD. Many still have residual symptoms, though. Additionally, research also shows two serotonin-norepinephrine reuptake inhibitors SNRIs , specifically Cymbalta duloxetine and Effexor venlafaxine , to be just as effective as first-line medications. If after 10 to 12 weeks SSRIs aren't significantly alleviating your symptoms, your doctor may decide to try augmenting your SSRI with an antipsychotic.
Augmenting involves adding a medication, in this case an antipsychotic, to improve the effectiveness of the original treatment. Two types of antipsychotic medications can be used to treat OCD: first-generation and second-generation antipsychotics. Second-generation antipsychotics, also known as atypical antipsychotic medications, are usually chosen to augment SSRIs.
Though Haldol can effectively treat OCD symptoms, it's been shown to be more likely to cause extrapyramidal side effects drug-induced movement disorders in some people than the atypical antipsychotics. There are no specific dosing recommendations for antipsychotic augmentation for OCD. Many experts believe antipsychotics should only be administered in low to medium doses. However, according to some studies, medium to higher dosages are more effective than lower doses.
Experts do agree, however, that using an antipsychotic to augment OCD treatment is nothing like using it for schizophrenia or bipolar disorder. Usually, much lower doses can be used to help treat OCD. In the end, it is really up to your doctor to decide the appropriate dose needed to treat your symptoms.
When using an antipsychotic to augment OCD treatment, it's a good idea to start with a lower dosage. Studies have shown that, at high doses, atypical antipsychotics may worsen OCD symptoms. She had horrible side effects from even Her OCD gradually improved quite dramatically. This is a common mistake. These medications are meant to be taken every day to keep your serotonin at a constant level. They are not taken like typical anti-anxiety meds, when you feel upset or anxious.
It is best not to miss doses if possible. However, if you do miss a dose here or there, it is unlikely that any bad effect on OCD will occur. In fact, sometimes your doctor might tell you to skip doses to help manage troublesome side effects, like sexual problems. Although any licensed physician can legally prescribe these drugs, it is probably best to deal directly with a board-certified psychiatrist who understands OCD.
It is important to find a psychiatrist who has special knowledge about the use of drugs to treat mental health disorders. Click here to find a psychiatrist in your area. Look for therapists with an MD or DO after their name. Usually with help from a doctor that you trust, your fears can be overcome. If you have fears about taking medication, ERP can be started first and part of the therapy can focus on these fears of medications.
It is important not to give up on a medication until you have been taking it as prescribed for 10 to 12 weeks.
Many patients feel no positive effects for the first few weeks of treatment but then improve greatly. No one knows how long patients should take these medications once they have been effective. Some patients are able to stop their medications after a 6 to month treatment period.
It does appear that over half of OCD patients and maybe many more will need to be on at least a low dose of medication for years, perhaps even for life.
It seems likely that the risk of relapse is lower if patients learn to use behavior therapy techniques while they are doing well on medications. If you have more severe OCD, you may need a longer course of treatment.
The main medicines prescribed are a type of antidepressant called selective serotonin reuptake inhibitors SSRIs. Most people need treatment for at least a year. You may be able to stop if you have few or no troublesome symptoms after this time, although some people need to take an SSRI for many years. Do not stop taking an SSRI without speaking to your doctor first because suddenly stopping can cause unpleasant side effects.
Treatment will be stopped gradually to reduce the chance of getting side effects. Your dose may need to be increased again if your symptoms return.
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