On the other hand, significantly more patients in the “taper group” were removed from the study for overall clinical worsening as rated by their clinician compared with those who stayed on their SRI medicine (45% versus 24%) this seemed to occur in those who tapered off of SRI medicines that have a short biochemical “half-life.” Half-life is a measure of how long a medicine persists in the system after a dose is taken. Yet about half of patients in both groups-SRI “taper” and “continuation”-maintained wellness, as measured by the standard OCD symptom severity test. This is to say, OCD symptoms, on average, got a bit worse in both groups, as did depression scores and quality of life scores.
Patients in both groups exhibited “small, clinically insubstantial worsening in symptoms” over the 24 weeks, the researchers noted.
OCD MEDICATION TRIAL
By this, the researchers mean that those who stopped receiving active SRI medicines during the 24 weeks of the trial had outcomes on these measures that did not significantly differ at week 24 from participants who continued to take their SRI medicines throughout the trial. The trial, which took 5 years to complete, resulted in a finding of “noninferior outcomes” for the “taper” strategy, based on clinical measures for OCD, depression, and quality of life.
Neither the participants nor those who treated and monitored their symptoms knew which groups the participants were assigned to. Those in the “taper” group received decreasing dosages of their SRI over the first 4 weeks of the trial (25% lower dosage each week), after which they were given identical-looking but inactive placebo pills. The 101 participants were randomly assigned to the two groups. Results of the trial were reported in JAMA Psychiatry. Wellness was defined relative to a scale that is commonly used to assess OCD symptom severity. The trial involved repeated assessment over 24 weeks of not only OCD symptoms in each participant, but also accompanying symptoms of depression, where present, as well as overall quality of life. Together, they and their research teams conducted a randomized clinical trial in which 51 OCD patients achieving wellness after upto 25 EX/TR therapy sessions tapered their SRI dose, while 50 patients also attaining wellness after EX/RP continued taking their SRI medicine. Foa, Ph.D., of the University of Pennsylvania Perelman School of Medicine, wanted to know whether OCD patients taking an SRI medication who are able to attain “wellness” after augmenting that therapy with EX/RP treatments can safely “taper” their SRI dose to the point where they cease taking the medicine altogether. Many who have experienced positive results have been able to use EX/RP strategies to manage OCD symptoms over the long-term.ĭr. The therapist also works with the patient to reduce or eliminate responding to obsessions with compulsive behaviors or rituals. The therapist helps the patient with gradual and systematic exposures to obsessions or objects, situations, mental images and thoughts, or other stimuli that trigger anxiety and obsessions. Treatment of OCD with EX/RP typically consists of 15-20 individual therapy sessions of about 90 minutes each. Patients who continue to suffer OCD symptoms can switch to another SRI medicine and/or augment their SRI treatment with another medication or a form of therapy called exposure/response prevention (EX/RP). While SRIs help many OCD patients, “most continue to exhibit clinically significant symptoms affecting their quality of life,” according to a research team co-led by Helen Blair Simpson, M.D., Ph.D., a 2010 BBRF Independent Investigator and 2005 Young Investigator at Columbia University and the New York State Psychiatric Institute. SRIs are the only medications so far approved by the FDA for treating OCD. The first-line treatment for adult obsessive-compulsive disorder (OCD) is typically a prescription for an SRI (serotonin reuptake inhibitor) drug, medications most often used to treat depression.
0 kommentar(er)
