Obsessive-compulsive caused

Obsessions (which cause anxiety) and or compulsions (which serve to neutralise anxiety)... 

The efficacy of benzodiazepines in most anxiety disorders has been proved through extensive clinical experience and controlled trials (Faravelli et al. 2003), although it is important to note that they are not effective at treatingpost-traumatic stress disorder or comorbid depression, and there is less evidence to support their use in obsessive-compulsive disorder (OCD). Their anxiolytic effects have an immediate onset and in contrast to many other drugs, they do not cause a worsening of anxiety when therapy is initiated. 

Conditions in the immune system also seem to play a role in OCD. This connection arose because the development of a movement disorder called Sydenham s chorea, which occurs in children following a particular type of bacterial infection that causes rheumatic fever, also often produces obsessive-compulsive behaviors. 

Golden RN, Morris JE, Sack DA Combined lithium-tricyclic treatment of obsessive-compulsive disorder. Biol Psychiatry 23 181-185, 1988 Goldenberg G, Lang W, Podreka 1, et al Are cognitive deficits in Parkinson s disease caused by frontal lobe dysfunction Journal of Psychophysiology 4 137-144, 1990 Goldgaber D, Harris HW, Hla T Interleukin-1 regulates synthesis of amyloid beta-protein precursor mRNA in human endothelial cells. Proc Natl Acad Sci U S A 86 7606-7610, 1989... 

There were two cases of hypertension from the United States, or possible serotonin syndrome reported with fluvoxamine while on St. John s wort concomitantly. A 44-year-old male with obsessive-compulsive disorder received fluvoxamine and experienced severe hypertensive crisis (160-170/ 120mmHg) after two tablets of St. John s wort. The physician stated that the reaction was probably due to the combination of fluvoxamine and St. John s wort, which has MAOI activity. A 38-year-old male was on fluvoxamine for approximately two months and hypericum 600 mg daily for approximately two weeks before reporting possible serotonin syndrome with severe bitemporal headache. He was hospitalized to rule out myocardial infarction. There were no electrocardiogram (EKG) changes or apparent causative pathology. Symptoms resolved on discontinuation of both drugs. 

Fluoxetine Highly selective blockade of serotonin transporter (SERT) little effect on norepinephrine transporter (NET) Acute increase of serotonergic synaptic activity slower changes in several signaling pathways and neurotrophic activity Major depression, anxiety disorders panic disorder obsessive-compulsive disorder post-traumatic stress disorder perimenopausal vasomotor symptoms eating disorder (bulimia) Half-lives from 15-75 h oral activity Toxicity Well tolerated but cause sexual dysfunction Interactions Some CYP inhibition (fluoxetine 2D6, 3A4 fluvoxamine 1A2 paroxetine 2D6)... 

Obsessive-compulsive disorder (OCD) is a syndrome characterized by obsessions and/ or compulsions, which together last at least an hour per day and are sufficiently bothersome that they interfere with one s normal social or occupational functioning. Obsessions are experienced internally and subjectively by the patient as thoughts, impulses, or images. According to standard definitions in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), obsessions are intrusive and inappropriate and cause marked anxiety and distress. Common obsessions are listed in Table 9—1. 

The obsessions or compulsions caused marked distress, are time-consuming (take more than 1 hour per day), or significantly interfere with occupational or academic functioning or with usual social activities or relationships. 

Fluoxetine (Prozac] Moderate, selective inhibition of serotonin reuptake No sedative, anticholinergic, or cardiovascular side effects helpful in obsessive-compulsive disorder May cause anxiety, nausea, insomnia long half-life can lead to accumulation... 

Physicians use benzodiazepines to treat many disorders, including a number of anxiety disorders. These include acute anxiety, panic disorder, post-traumatic stress disorder, and obsessive-compulsive disorder. In addition, benzodiazepines can be used to treat agitation or anxiety that is caused by other psychiatric conditions such as acute mania, psychotic illness, depression, impulse control disorders, and catatonia or mutism. 

Meanwhile, the stimulants have no proven therapeutic effect beyond the first few weeks of behavioral suppression with enforced docility and compulsivity. Furthermore, they have no positive impact on learning, academic progress, or socialization. Instead, they disrupt learning by causing abnormal overfocusing, and they often induce obsessive-compulsive behavior, depression, and social withdrawal. 

In three other cases, olanzapine caused significant exacerbation of obsessive-compulsive symptoms in schizophrenia (two cases) and obsessive-compulsive disorder (one case) (151). 

In one case, reintroduction of risperidone did not cause obsessive-compulsive symptoms to re-emerge in a 29-year-old man who had previously developed obsessive-compulsive features when first treated with risperidone (136). 

Psychiatric adverse effects have not previously been reported with azathioprine. Neither does the database of the WHO Uppsala Monitoring Centre mention obsessive-compulsive symptoms or panic attacks as a possible adverse effect of azathioprine. However, the time course in this case and the absence of symptoms before and after azathioprine therapy suggest a causal relation. It is possible that the combination of subtle cerebral dysfunction as a result of the vasculitis and the use of azathioprine may have caused the symptoms in this patient. 

Isoniazid can cause neuropsychiatric syndromes, including euphoria, transient impairment of memory, separation of ideas and reality, loss of self-control, psychoses (421), and obsessive-compulsive neurosis (422). Isoniazid should be used with caution in patients with pre-existing psychoses, as it can cause relapse of paranoid schizophrenia (423). Patients on chronic dialysis appear to be vulnerable to neurological adverse drug reactions, because of abnormal metabolism of uremic toxins. It is therefore recommended that a... 

In 800 Yemeni adults (aged 15-76 years) sjmptoms that might have been caused by the use of khat were elicited by face-to-face interviews 90 items covered nine scales of the following domains somatization, depression, anxiety, phobia, hostility, interpersonal sensitivity, obsessive-compulsive, hostility, interpersonal sensitivity, paranoia, and psychoticism (17). At least one life-time episode of khat use was reported in 82% of men and 43% of women. The incidence of adverse psychological symptoms was not greater in khat users, and there was a negative association between the use of khat and the incidence of phobic symptoms. 

It is well recognized that in vulnerable individuals, methylphenidate can induce or aggravate Tourette s syndrome, most often characterized by motor tics and occasionally vocal tics (21). Moreover, obsessive-compulsive symptoms caused by methylphenidate have also been reported (22,23). However, it is not clear whether explosive episodes associated with Tourette s syndrome are an integral part of the disorder or occur as part of a co-morbid disorder, predominantly ADHD or obsessive-compulsive disorder. In this case the explosive episodes coincided with a period of treatment with methylphenidate. In view of the extreme, sudden, discrete nature of the outbursts and the temporal relation to treatment, it was concluded that the episodes were behavioral problems caused by methylphenidate, rather than a feature of the underlying ADHD. 

Obsessive-compulsive disorder (OCD) involves recurrent obsessions and compulsions, which are severe enough to cause marked distress and major functional impairment. The sufferer is aware that the obsessions and com-pulsionsare unreasonable, but is powerless to stop them. Obsessions are recurrent, unwanted thoughts or images, whereas compulsions are repetitive acts or rituals. The individual typically feels compelled to perform compulsions to alleviate the anxiety associated with an obsession, or to prevent the occurrence of some dreaded event. The lifetime prevalence of OCD is estimated at 2.3% (14). 

Over 90% of children with Tourette s disorder have coexisting conditions such as ADHD (75%), mood disorders (60%), obsessive-compulsive disorder (40%), other anxiety disorders, or a combination of comorbidities." " Tourette s disorder itself does not cause diminished intellectual functioning however, the severity of tics and associated illnesses can result in significant impairment in school functioning, sometimes necessitating special education classes." " ... 

Therapeutic trials (6 to 8 weeks) of an SSRI or clomipramine should be tried when obsessive-compulsive, anxiety, or depressive symptoms cause functional impairment in patients with Tourette s disorder. Careful monitoring for behavioral activation, disinhibition, and motor restlessness is essential during SSRI or clomipramine therapy, because these symptoms occur in 20% to 40% of children and may require drug discontinuation. ... 

Obsessive-compulsive disorder (OCD) is one of the ten leading causes of disability. Patients with OCD experience significant impairment in their quality of life (QOL), with reductions in social, family, and occupational functioning." OCD affects far more individuals than was thought in the past. Because of the nature and potential severity of signs and symptoms and the resultant negative effects on QOL, OCD is considered a major medical condition. Clinicians should be able to identify OCD and nnderstand the current treatment options. 

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