OCD Flashcards
These help controls OCD symptoms where dopamine agonist can worsen symptoms
Serotonergic reuptake inhibitors
This is classified separately from anxiety disorders.
OSC
this dysfunction is also associated with OCD
Dysfunction of the cortico-thalamo-cortical circuit
Symptoms of OCD
obsessions and compulsion
Anxiety-provoking unwanted and repetitive thoughts, images or urges that are difficult to control
Obsessions
Repetitive behaviours to reduce anxiety
Compulsions
Goals of therapy
Reduce the incidence and intensity of obsessions
Reduce the time spent acting on compulsion
Optimize patient functioning and quality of life
Prevent recurrence of symptoms
Treat comorbidities
Minimize side effects of txt
Induce remission (long-term goal)
Diagnostic criteria as per DSM-5
- Presence of obsessions/compulsion
- Patient has recognized that such behaviours are excessive/unreasonable
- Behaviours are causing distress, are time-consuming, and are intereferring with daily activities
- Behaviours are not due to substance abusing or medical conition
Causes of OCD
Medical conditions and drugs
What are the medical conditions that causes OCD?
History of head injuries neurocognitive disorders (alzheimer's, parkinsons)
What are the drugs that causes OCD?
stimulants (cocaine)
dopamine agonist (pramipexole, ropinirole)
SGAs (olanzapine)
What are the risk factors that causes OCD?
Age social isolation history of physical abuse negative emotionally family history (genetic component)
Possibel non-pharmacological options to treat OCD:
- Cognitive behavioural therapy (CBT)
- Exposure and response preventions (ERP)
- rTMS (repetitive transcranial magnetic stimulation)
- Deep brain stimulation
Is the 1st line non-pharmacological therapy to txt mild to moderate OCD with or without pharmacotheraphy?
CBT
For how long the benefits of CBT remains?
1-5 yrs
This non-pharmacological therapy is a specialized type of CBT for OCD and it is commonly practiced?
ERP
This non-pharmacological therapy involves magentically stimulating certain areas of brain and can be considered in refractory OCD
rTMS
This non-pharmacological therapy involves in insertion of a small neurostimulator into a targeted brain area and can be considered in refractory OCD?
Deep brain simulation
This is the 1st line pharmacological therapy to treat OCD?
SSRIs
What are the some examples of SSRIs:
Escitalopram Fluoxetine Fluvoxamine Paroxetine sertraline
This is the 2nd line pharmacological therapy to treat OCD?
Citalopram
venlafaxine
clomipramine
mirtazapine
These drugs can be more effective than SSRIs for comorbid pain/comorbid major depressive disorder:
Clomipramine and venlafaxine
This drug has similar effectiveness to SSRIs in OCD but has lower tolerability due to anticholinergic and antihistaminic effects. ANd it should be taken with food
Clomipramine
This drug causes significant weight gain but has lowr risk of sexual dysfunction
mirtazapine
What are the 1st line pharmacological AUGMENTATIVE txt options?
SGAa as augmentative
Examples of SGAs
Aripiprazole
risperidone
2nd line pharmacological AUGMENTATIVE txt options?
Memantine
Quetiapine
topiramate
3rd line of pharmacological AUGMENTATIVE txt options?
Olanzapine amisulpride ziprasidone haloperidol mirtazzapine celecoxib granisetron IV ketamine ondansetron N-acetylcysteine riluzole lamotrigine
Natural health products to treat OCD?
Milk thistle
Valerian root
St.John’s wort
This natural health product to treat OCD can cause serotonergic activity and may cause serotonin syndrome when administered with other SSRIs?
St.John’s wort
This drug is linked with fetal cardiovascular malformations
paroxetine
Recommended txt for OCD in preganancy, breastfeeding and pediatric pts?
CBT is 1st line
Recommended txt for OCD in preganancy if symptoms are severe?
SSRIs
