Goals of OCD Pharmacologic Treatment
Receptor balance is key.
- 5HT2 and 5HT2 - from raphe nuclei - (resulting in decrease in OCD, depression and anxiety and increase in sexual side effects) Accomplished with SSRI/SRI drugs.
- 5HT1A (resulting in decrease in sexual side effects) Accomplished with Buspar.
- Striatal D1 and D2 and Metabolic GluCmGlu (resulting in decrease in OCD, anxiety and depression) Accomplished with Inositol.
- Arginine, vasopressin (AVP) and oxytocin are negatively correlated with OCD - but not in OCD with tics! = complex.
- Homovanillic acid is primary central dopamine metabolite - Inositol.
- OCD patients has lower level of adrenocorticotropic hormone (ACTH) due to pituitary desensitization to persistently elevated CSF corticotrophin releasing factor (CRF