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OCD - Treatment Research

Inositol A 2011 literature review suggested that the naturally occurring sugar inositol can be used as a treatment for obsessive-compulsive disorder (OCD).[1] The literature review says that inositol may potentially correct hyperactivity in the phosphoinositide pathway but the exact mechanisms in which inositol exerts its therapeutic effects are unknown.[1] Due to the vague language used in the review, the paper has low construct validity. The authors make claims about inositol as a treatment for OCD but do not back it up with concrete facts and research. Furthermore, a 1999 study found negligible effects of inositol on OCD symptoms.[2] While this study was small with only ten participants, it still has external validity due to the fact that these participants were randomly recruited through the Anxiety Disorders Clinic.[3] Being that this was a within-groups design, there is a threat to internal validity due to the possibility of order effects where participants’ reactions to one condition are influenced by their reaction to a previous condition.[3] They avoided these order effects by using counterbalancing.[2] Half of the participants first received a placebo and then eight weeks later switched to inositol while the other half did the opposite. The order of the treatments was randomized and double-blind which also helped increase the internal validity of the study.

Hydrocodone and fluoxetine It has also been suggested that opioids like hydrocodone can be used as a treatment for OCD. In a 2005 study, hydrocodone was found to have positive effects on OCD patients, however, it was only effective in severe OCD patients. It also only helped to alleviate symptoms, it did not get rid of symptoms altogether.[4] Furthermore, when taken in conjunction with fluoxetine, the effects of hydrocodone can be negated.[5] However, fluoxetine, taken alone, can also help alleviate symptoms of OCD. In a study from the early 1990s, fluoxetine was found to help treat OCD symptoms.[4] The study had 355 participants and they completed a randomized, double-blind placebo control study. Participants received either a placebo or fluctuating amounts of fluoxetine over a 13 week period (either 20 mg, 40 mg, or 60 mg per day). The results showed that participants who received 40 mg or 60 mg of fluoxetine per day experienced an improvement in their symptoms.[4] This study is high in internal validity because it addresses the three threats to internal validity. These threats include demand characteristics, observer bias, and placebo effects. Demand characteristics refer to participants who guess what the study is actually about and change their behavior accordingly. Observer bias is when a researcher’s expectations influence their data interpretation. Finally, placebo effects are when participants believe they are receiving the real treatment so they report improvement regarding symptoms.[3] Conducting a double-blind placebo control study avoids all of these threats. Both participants and researchers did not know who was in the control group and who was in the manipulation group and both parties did not know who was given the placebo versus the real drug.

Paroxetine Paroxetine is a serotonin reuptake inhibitor (SSRI) that has also been theorized to treat OCD symptoms. One study looked at 201 patients with OCD and found that paroxetine improved symptoms when compared to a placebo.[4] This study was multinational, meaning the participants came from various nations. This increases the external validity of the study because including participants from various places makes the results more generalizable. Furthermore, the participants were chosen via random selection which also increases the external validity of the study.

Topiramate Research surrounding OCD treatment is greatly concerned with agents that influence the release of glutamate or the binding to its receptors. One of these agents is topiramate. One study found positive results of topiramate being an effective treatment for OCD. Out of the 16 participants, 11 of them had positive effects after taking the topiramate. Specifically, seven of the participants felt “much improved” while four felt “very improved”.[6]

References 1. ^ a b Camfield, D. A., Sarris, J., & Berk, M. (2011). Nutraceuticals in the treatment of obsessive compulsive disorder (OCD): A review of mechanistic and clinical evidence. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 35, 887-895. 2. ^ a b Fux, M., Benjamin, J., & Belmaker, R. H. (1999). Inositol versus placebo augmentation of serotonin reuptake inhibitors in the treatment of obsessive-compulsive disorder: A double-blind cross-over study. International Journal of Neuropsychopharmacology, 2, 193-195. 3. ^ a b c Morling, B. (2018). Research Methods in Psychology: Evaluating a World of Information. W.W. Norton & Company, Inc. 4. ^ a b c d Davidson, J., & Bjorgvinsson, T. (2003). Current and potential pharmacological treatments for obsessive-compulsive disorder. Expert Opinion on Investigational Drugs, 12(6), 993-1001. 5. ^ Koran, L. M. (2007). Obsessive-compulsive disorder: An update for the clinician. Focus, 5, 299-313. 6. ^ Ameringan, M. V., Mancini, C., Patterson, B., & Bennett, M. (2006). Topiramate augmentation in treatment-resistant obsessive-compulsive disorder: A retrospective, open-label case series. Depression and Anxiety, 23, 1-5.