Scientists at the National Institutes of Health’s (NIH) National Institute on Alcohol Abuse and Alcoholism (NIAAA) have identified a previously unknown gene variant that doubles an individual’s risk for obsessive-compulsive disorder (OCD). The new functional variant, or allele, is a component of the serotonin transporter gene (SERT), site of action for the selective serotonin reuptake inhibitors (SSRIs) that are today’s mainstay medications for OCD, other anxiety disorders, and depression.
New research article publised in Archives of Pediatrics and Adolescent Medicine about neonatal abstinence syndrome (NAS). Its when an infant is exposed to selective serotonin reuptake inhibitors (SSRIs) (New Antidepressiva) like Zoloft, Paxil/Seroxat etc. during pregnancy. After birth the infant is at risk for developing neonatal abstinence syndrome (NAS), a withdrawal disorder characterized by high-pitched crying, tremors, and disturbed sleep, new research suggests.
OCD suffers not responding to standard drug and CBT treatment might get greater symptom improvement with high-dose drug treatment. The Journal of Clinical Psychiatry has published a research article about high-dose treatment:
High-Dose Sertraline Strategy for Nonresponders to Acute Treatment for Obsessive-Compulsive Disorder: A Multicenter Double-Blind Trial Objective: To evaluate the efficacy and safety of high-dose sertraline for patients with obsessive-compulsive disorder (OCD) who failed to respond to standard sertraline acute treatment.
Method: Sixty-six nonresponders to 16 weeks of sertraline treatment who met DSM-III-R criteria for current OCD were randomly assigned, in a double-blind continuation phase of a multicenter trial, either to continue on 200 mg/day of sertraline or to increase their dose to between 250 and 400 mg/day for 12 additional weeks. Efficacy measures included the Yale-Brown Obsessive Compulsive Scale (YBOCS), the National Institute of Mental Health Global Obsessive Compulsive Scale (NIMH Global OC Scale), and the Clinical Global Impressions-Severity of Illness and -Improvement (CGI-I) scales. Data were collected from July 26, 1994, to October 26, 1995.
Results: The high-dose (250-400 mg/day, mean final dose= 357, SD = 60, N = 30) group showed significantly greater symptom improvement than the 200-mg/day group (N = 36) as measured by the YBOCS (p=.033), NIMH Global OC Scale (p = .003), and CGI-I (p = .011). Responder rates (decrease in YBOCS score of > = 25% and a CGI-I rating < = 3) were not significantly different for the 200-mg/day versus the high-dose sertraline group, either on completer analysis, 34% versus 52%, or on endpoint analysis, 33% versus 40%. Both treatments showed similar adverse event rates.
Conclusion: Greater symptom improvement was seen in the high-dose sertraline group compared to the 200-mg/day dose group during continuation treatment. Both dosages yielded similar safety profiles. Administration of higher than labeled doses of selective serotonin reuptake inhibitors may be a treatment option for certain OCD patients who fail to respond to standard acute treatment.
(J Clin Psychiatry 2006;67:15-22) The research is rather old, done back in 1995 and another thing is its sponsored by Pfizer, the maker of the SSRI sertraline (Zoloft). At the other hand high-dose treatment is not a new thing and drugs like clomipramine (Anafrenil) and paroxetine (Paxil/Seroxat) have been tested too and proven effective. Evidence-based pharmacotherapy of obsessive-compulsive disorder. Fineberg NA, Gale TM., Int J Neuropsychopharmacol. 2005 Mar;8(1):107-29. Epub 2004 Sep 28. Read the entire article at the journals homepage A qualitative analysis of nonresponse: management of treatment-refractory obsessive-compulsive disorder, Pallanti S, Hollander E, Goodman WK., J Clin Psychiatry. 2004;65 Suppl 14:6-10.
Medscape Oct. 27, 2004.
News Author: Laurie Barclay, MD
Combined cognitive-behavior therapy (CBT) with sertraline may be best for adolescents with obsessive-compulsive disorder (OCD), according to the results of a randomized trial published in the Oct. 27 issue of JAMA. ï¿½The empirical literature on treatment of obsessive-compulsive disorder (OCD) in children and adolescents supports the efficacy of short-term OCD-specific cognitive behavior therapy (CBT) or medical management with selective serotonin reuptake inhibitors ([S]SRIs),ï¿½ write John S. March, MD, MPH, from Duke University Medical Center in Durham, North Carolina, and colleagues from the Pediatric OCD Treatment Study (POTS) Team. ï¿½However, little is known about their relative and combined efficacy.ï¿½ Læs resten