OCD Behavioral Treatments

The standard treatment of OCD includes psychotherapy (“talk therapy”) and antidepressant medication.

Follow the treatment plan prescribed by your doctor carefully. Never change or discontinue the treatment without consulting your doctor.

1) Cognitive Behavioral Therapy (CBT)

CBT has proven to be an effective method for treating OCD [R].

In a meta-analysis of 16 clinical trials and 756 people, CBT was proven to improve OCD symptoms [R].

2) Exposure and Response Prevention (ERP) Method

With ERP, a patient is first exposed to triggers and then should learn skills to stop the compulsions. The exposures can be images or descriptions that are read repeatedly to desensitize patients from their obsessions. By addressing both obsessions and compulsions, ERP has been proven to be more effective than addressing either one alone [R].

OCD Medication

Approved Drug Treatments

1) Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are the first-line treatments for OCD because they have few side effects [R].

One in five patients who take SSRIs for OCD has at least a 25% reduction in symptoms compared to placebo. Most people respond to SSRIs after six weeks. However, it is recommended to try the medication for at least eight to twelve weeks to have an effect. Evidence suggests that in order to avoid relapse, about six to twelve months of therapy is necessary [R].

Head-to-head trials between several SSRIs including fluvoxamine, paroxetine, citalopram, sertraline, and fluoxetine showed no difference in efficacy [R, R].

Each SSRI works slightly different from the other, therefore therapy is individualized to each patient’s characteristics. For example, fluoxetine may be preferred in those who forget to take their medication daily since it lingers in the body for weeks [R].

Overweight patients may benefit from either fluoxetine or sertraline since they are both associated with the lowest weight gain [R].

Citalopram can increase the risk of heart abnormalities with daily doses of over 20 mg. A recent study disproved this elevated risk to the heart. However, if an individual is suffering from heart issues, it may be in his/her best interest to avoid citalopram and use

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Disclaimer: This post is not a recommendation or endorsement for memantine. This medication is only FDA-approved for the treatment of certain specific medical disorders, and can only be taken by prescription and with oversight from a licensed medical professional. We have written this post for informational purposes only, and our goal is solely to inform people about the science behind memantine’s effects, mechanisms, and current medical uses.

What Is Memantine?

Originally developed in the 1960s to treat diabetes, memantine was approved by the FDA in the US in 2003 for the treatment of moderate-to-severe Alzheimer’s disease [R]. Memantine is commonly sold under the trade name Namenda.

Currently there are just five medications – including memantine – which have been approved for the treatment of cognitive decline in Alzheimer’s. The other four are all acetylcholinesterase inhibitors, which means that they work primarily by preventing the breakdown of the neurotransmitter acetylcholine. However, memantine works differently, by blocking NMDA receptors, making it the only drug in its class [R].

It is important to note that memantine and other Alzheimer’s drugs do not cure Alzheimer’s – they only slow some of the cognitive decline commonly seen in this disease. Therefore, these drugs are useful for improving the daily functioning and quality-of-life of Alzheimer’s patients; but they nevertheless do not reverse the course of the disease once it has started, nor do they fully prevent the disease from progressing over time.

Mechanism of Action

Memantine is believed to slow the neurotoxicity associated with Alzheimer’s disease and other neurodegenerative diseases [R].

Memantine’s main mechanism is through glutamate NMDA receptor inhibition in the brain. Too little or too much glutamate can lead to cell death. Memantine quickly binds to and blocks NMDA receptors, which can counteract toxicity caused by too much excitation (excitotoxicity), and thereby prevents programmed cell death (apoptosis) [R].

Memantine also blocks 5-HT3 (serotonin subtype 3) receptors. This receptor is found in several areas of the limbic system including the amygdala and hippocampus [R].

Memantine also blocks nicotinic receptors [R].

Finally, memantine may activate dopamine D2 receptors. This has only been studied in cell lines where memantine does bind to D2 receptors;

The post All About Memantine: Approved & Unofficial Uses + Side-Effects appeared first on SelfHacked.

What Is OCD?

Definition

OCD is a common and often chronic mental disorder that affects up to 2 to 3% of adults and up to 1% of children [R].

The OCD Cycle: Obsessions (repetitive thoughts) and compulsions (repetitive actions) characterize OCD. The disorder begins with an obsession that leads to anxiety, which then leads to compulsions to relieve this anxiety [R].

According to the American Psychiatric Association [R]:

• Obsessions are defined as “persistent ideas, thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress”
• Compulsions are defined as “repetitive behaviors or mental acts the goal of which is to prevent or reduce anxiety or distress, not to provide pleasure or gratification”

Around 30 to 50% of individuals with OCD are often diagnosed before the age of 10. There may be a difference between childhood and adult-onset OCD. However, there is no definite explanation for this hypothesis [R, R].

Types

The obsessions and compulsions can be unique to each individual. Four to five symptom clusters or OCD types are common, and each has its associated obsessions and compulsions [R, R, R]:

1. Checking: Forbidden or instrusive thoughts (aggressive, sexual, religious, or somatic obsessions) and checking compulsions
2. Instrusive Thoughts: Obsessions with no clear compulsion (may involve the same forbidden or instrusive thoughts a the first type but compulsions can be mental)
3. Contamination: Contamination obsessions with cleaning compulsions
4. Symmetry: Symmetry obsessions with ordering and counting compulsions
5. Hoarding: Although hoarding is sometimes added as the fifth category (as a specific compulsion), DSM-V now recognizes it as a separate condition.

These are expanded upon with some examples below, which highlight why OCD can be difficult to diagnose.

OCD Symptoms and Diagnosis

Diagnosing OCD can be difficult because individuals often feel shame and are secretive about their symptoms [R].

The staging of the disorder is:

Obsession → anxiety → compulsion → relief [R]

Various

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What Is Muira Puama?

Muira puama or potency wood (Ptychopetalum olacoides) is a species of small trees native to the Amazon rainforest of Brazil, French Guiana, Guyana, and Suriname [R].

Constituents of Muira Puama

The root and bark of muira puama are rich in alkaloids, phenolic compounds, fatty acids, fatty acid esters, essential oils, plant sterols, and triterpenes. Its main components include [R]:

• Alkaloids: menisperine, magnoflorine, moschamine
• Flavonoids: luteolin and derivatives
• Phenolic acids: caffeic, ferulic, vanillic, syringic

Eight diterpenoids in muira puama’s bark have been described [R]:

• 7-oxo-kolavelool
• 7alpha-hydroxykolavelool
• 6alpha,7alpha-dihydroxykolavenol
• 12-oxo-hardwickiic acid
• ptycholide I
• ptycholide II
• ptycholide III
• ptycholide IV

Diterpenoids are natural compounds with potential antibacterial, anticancer and anti-inflammatory properties [R].

Health Benefits

Muira puama is commercialized in supplements for sex drive and several other uses, many of which remain unproven. Due to the lack of solid clinical research, muira puama is not approved by the FDA for medical use. Regulations set manufacturing standards for them but don’t guarantee that they’re safe or effective. Speak with your doctor before supplementing with muira puama.

Possibly Effective as:

Aphrodisiac

In two studies, muira puama increased sexual desire in 60% of men with initial low libido and improved erectile function in 50% of men with a poor erection. Muira puama also improved sexual desire, sexual fantasies, and the ability to reach orgasm in 65% of women with sexual dysfunctions [R].

In another study, muira puama combined with ginkgo biloba (Herbal vX, 175 mg muira puama and 16 mg of gingko) increased libido in 65% of 202 women who reported low sex drive [R].

Muira puama supplements of (1,000 – 1,500 mg daily) for 2 weeks increased libido in 60% of 262 men with low libido [R].

Although limited, the evidence suggests that muira puama may work as an aphrodisiac. You may try it to improve your sex drive if your doctor considers that it may help in your case.

Insufficient Evidence for:

1) Erectile Dysfunction

In a clinical trial on

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