Obsessive-Compulsive Disorder (OCD)
Potential Adjunctive Treatment for OCD Patients who do not Adequately Respond to Treatment with a Seratonin Reuptake Inhibitor
Need more help for your OCD? Many people with OCD experience only a partial response to currently available medications.
Montefiore Medical Center and multiple sites across the U.S. are seeking volunteers to participate in a clinical trial evaluating the effectiveness of low-dose ondansetron augmentation for the treatment of
Participants must have a DSM-IV-TR diagnosis of OCD as their primary disorder who have been on a stable treatment regimen of clomipramine, fluvoxamine, fluoxetine, paroxetine or sertraline for at least 6 weeks may be eligible for this study. Six additional weeks of stable SRI treatment, without adequate clinical response, will be required prior to randomization, after which the participant will receive SRI plus study drug, for a total of 12 more weeks.
Exclusion criteria include, but are not restricted to the following:
• Failure to respond to more than 2 SRI treatments prior to current SRI
• Hoarding as primary OCD symptom
• Current or past medical history of schizophrenia or other psychotic disorders, schizotypal personality disorder, bipolar disorder, Tourette syndrome, autism or autistic spectrum disorders, eating disorders, PTSD
• Requiring active behavioral therapy
• History of drug addiction or drug, alcohol or other substance abuse within the past 12 months
• Currently taking, or having taken within the previous 8 weeks, any of the following: other SRls, antipsychotic drugs, lithium, benzodiazepines or other anxiolytics, carbamazepine, oxcarbazepine, phenytoin, or other anti-depressants (including St. John's Wort)
• Likely to use triptans at any time during the study
• Believed to have suicidal or homicidal risk
People often jokingly point to odd habits or tidiness as signs of obsessive-compulsive disorder, or OCD. But the truth is OCD is a very real disorder that affects more than 2 million Americans, and there is a big difference between maintaining a morning routine or keeping a clean home and living with the disorder.
We at the Bio-Behavioral Institute in Great Neck, NY are investigating the role of certain emotions in individuals with body dysmorphic disorder (BDD), obsessive-compulsive disorder (OCD), or hoarding.
Individuals who have been diagnosed with one or more of the following:
- body dysmorphic disorder (BDD)
- obsessive-compulsive disorder (OCD)
OCD burdened a bright young woman for more than 10 years. Read all about her recovery and her advice to others who are suffering in Working Toward Compassion and Moderation.
Episodic OCD burdened me for over a decade, from my college years until 2006. Self-punishment made matters worse, as it does for everyone. I compulsively checked the coffee maker to see if it was off, and overchecked my written work. I feared I had inadvertently written embarrassing or unkind Freudian slips.
My son Dan was in college, and by the time I arrived at his dorm, he had not eaten in more than a week. He was spending hours at a time sitting in one particular chair, hunched over with his head in his hands, doing absolutely nothing. He could not enter most of the buildings on campus and could only do minimal amounts of work at specific times. To top it all off, he was self-injuring. My son was in the throes of severe OCD.
The anxiety and shame started when Diance was 25. She was sitting in a pew at her church, where she is active in the ministry. It seemed to come out of nowhere. She felt as if she were going to jump out of her skin.
Diance doesn’t know why she felt so anxious. But she knows what she saw when the feeling overwhelmed her: a nearby woman wearing a v-neck sweater.
This study uses functional magnetic resonance imaging (fMRI) to learn how the brain functions in adolescents receiving fluoxetine (Prozac) or cognitive behavioral therapy (CBT) for anxiety or depression in children/adolescents. All participants will receive interviews to assess how they are doing in general, including his or her general mood, degree of nervousness and behavior. Each participant and one of his or her parents will be interviewed separately and together.
Age: 8 to 17
Consent: Can give consent/assent. (Parents will provide consent; minors will provide assent.)
IQ: All subjects will have IQ greater than 70 (Assessment relies on WASI)
SUBJECTS WITH AN ANXIETY DISORDER
Diagnosis: Current Diagnosis of Social Phobia, Separation Anxiety, or Generalized Anxiety Disorder (Based on K-SADS)
Symptom Severity: Score greater than 9 on PARS (This score was used to enroll subjects in previous trial demonstrating efficacy of an SSRI in pediatric anxiety.)
Clinical Impairment: CGAS less than 60
SUBJECTS WITH A MOOD DISORDER
Diagnosis: Current Diagnosis of Major Depression (Based on K-SADS (juveniles) or SCID (adults))
Clinical Impairment: CGAS less than 60 (juveniles) GAS less than 70 (adults)
Symptom Severity: CDRS Score greater than 39 (juveniles) (This score was used to enroll subjects in previous trials demonstrating efficacy of an SSRI in pediatric depression.)
Consent: Can give consent/assent.
IQ: All subjects will have IQ greater than 70. Assessment relies on WASI.
Any serious medical condition or condition that interferes with fMRI scanning, and for patients electing medication, any condition that increases risk of SSRI treatment. All patients will have complete physical examination. Healthy volunteer participants will be medication-free and have no current serious medical conditions, based on a review of their medical history.
Current use of any psychoactive substance; current suicidal ideation; current diagnosis of attention deficit hyperactivity disorder (ADHD) of sufficient severity to require pharmacotherapy. These factors could complicate treatment with an SSRI. No subject on medication will be accepted into the trial. Subjects will not be taken off of medications to enter the trial.
Current diagnoses: Tourette's, OCD, posttraumatic distress disorder, conduct disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression
Past or current history of mania, psychosis, or pervasive developmental disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression
Recent use of an SSRI: All subjects must have been free of any SSRI use for at least one month (fluoxetine six months) and must not have been treated with an SSRI for their current depressive episode. This is designed to exclude subjects who have failed a trial of an SSRI for their current episode of major depression.
HEALTHY ADULT SUBJECTS
Any current psychiatric diagnosis. Assessment relies on SCID.
SUBJECTS WITH AN ANXIETY DISORDER
Current Major Depressive Disorder