OCD: When you can’t stop doing what you’re doing

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About one in 50 people suffers from obsessive compulsive disorder, a disease that turns intrusive thoughts into compulsive behaviors.

Antidepressants help with OCD, but investigators in Texas are trying new medications targeting different brain messengers.

OCD only affects about 2 percent of the population, but symptoms are usually severe. But clinical trials are targeting new receptors in the brain, and that might mean positive news on the medical horizon.

OCD is a chronic, mental disorder where thoughts you don’t want become behaviors that you can’t stop. OCD severely impacts quality of life. Just ask the expert, who is also a patient.

“I’ve lived with OCD since childhood," Baylor College of Medicine assistant professor Dr. Elizabeth McIngvale said. "I was diagnosed when I was 12 and have been in treatment ever since.”

She used to ask her mom if it was OK that she touched something in school.

“Then, it transferred into a lot of contamination rituals, spending a lot of time in the shower," McIngvale said. "Fearing I hadn’t done something enough, I wasn’t clean enough. I was going to contaminate other people.”

OCD is rooted in fear, which feeds the anxiety and brings about the unwanted behavior.

Psychologists used cognitive behavioral therapy in some cases, as well as traditional antidepressants aimed at serotonin and dopamine brain messengers.

But researchers are now seeking something new: glutamate in the brain, a neurotransmitter that sends signals to other cells.

“Some recent information suggests that there might be a third messenger that naturally occurs called glutamate, thereby have improved response to antidepressants," Baylor College of Medicine professor Dr. Eric Storch said.

And for Elizabeth McIngvale, who might only get several minutes a day without intrusive thoughts, it’s clearly critical to find a better way.

“I can understand someone’s pain and I can truly believe with all my belief system that they can get better,” she said.

The study of this new drug is being conducted at 59 centers across the country. And McIngvale has also started the Peace of Mind Foundation, dedicated to providing help to people with OCD.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: OCD: WHEN YOU CAN’T STOP DOING WHAT YOU’RE DOING
REPORT: MB #4549

BACKGROUND: OCD stands for obsessive compulsive disorder. It is a mental illness that causes either obsessive urges or thoughts or compulsive and repetitive behaviors, or both. The disorder affects jobs, relationships and normal life. Symptoms begin with thoughts. Usually they do not make sense, but people do them because they cannot quit and if they do not finish, they are compelled to start again. Examples of some of these thoughts are fear of germs, hurting others, doing things in a certain order or a certain number of times.
(Source: https://www.webmd.com/mental-health/obsessive-compulsive-disorder#1)

TREATMENTS: Patients are given physical exams, lab exams, and psychological exams. Doctors use the criteria in the Diagnostic and Statistical Criteria Manual for Mental Disorders. One problem diagnosing OCD is that the tests can suggest other mental disorders, but you can have more than one diagnosis. Doctors can send patients to cognitive behavioral therapy, which is the most common treatment. Exposure and responsive prevention is a type of CBT that exposes patients to the thing they fear. Prozac and Anafranil are FDA approved medications that can be given to children. For adults, they can take Zoloft or Paxill to help. The risks with medications are the side effects, possible suicide risk and how it reacts with other substances.
(Source: https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/drc-20354438)

NEW TECHNOLOGY: Researchers have been looking into glutamate. Glutamate is the most abundant excitatory neurotransmitter in the brain. It helps with communication with cells in all the circuits in the nervous system. Too much can cause neuron damage which can lead to conditions like stroke or ALS. The levels of glutamate could be high as a consequence of OCD. There are many medications out there now that can help lower the levels. Rilutek, an FDA approved medication for ALS, helped in some patients. The medication can not only help adults but they also help children. Namenda, a memantine, affects how the neurons respond to glutamate. It is FDA approved, and it can benefit both kids and adults going through normal therapy. Researchers want to do a more controlled study in order to better understand the drug’s impact.
(Source: https://iocdf.org/expert-opinions/expert-opinion-glutamate/)