OCD

Question 1

These help controls OCD symptoms where dopamine agonist can worsen symptoms

Answer 1

Serotonergic reuptake inhibitors

Question 2

This is classified separately from anxiety disorders.

Answer 2

OSC

Question 3

this dysfunction is also associated with OCD

Answer 3

Dysfunction of the cortico-thalamo-cortical circuit

Question 4

Symptoms of OCD

Answer 4

obsessions and compulsion

Question 5

Anxiety-provoking unwanted and repetitive thoughts, images or urges that are difficult to control

Answer 5

Obsessions

Question 6

Repetitive behaviours to reduce anxiety

Answer 6

Compulsions

Question 7

Goals of therapy

Answer 7

Reduce the incidence and intensity of obsessions
Reduce the time spent acting on compulsion
Optimize patient functioning and quality of life
Prevent recurrence of symptoms
Treat comorbidities
Minimize side effects of txt
Induce remission (long-term goal)

Question 8

Diagnostic criteria as per DSM-5

Answer 8

1. Presence of obsessions/compulsion
2. Patient has recognized that such behaviours are excessive/unreasonable
3. Behaviours are causing distress, are time-consuming, and are intereferring with daily activities
4. Behaviours are not due to substance abusing or medical conition

Question 9

Causes of OCD

Answer 9

Medical conditions and drugs

Question 10

What are the medical conditions that causes OCD?

Answer 10

History of head injuries
neurocognitive disorders (alzheimer's, parkinsons)

Question 11

What are the drugs that causes OCD?

Answer 11

stimulants (cocaine)
dopamine agonist (pramipexole, ropinirole)
SGAs (olanzapine)

Question 12

What are the risk factors that causes OCD?

Answer 12

Age
social isolation
history of physical abuse
negative emotionally
family history (genetic component)

Question 13

Possibel non-pharmacological options to treat OCD:

Answer 13

1. Cognitive behavioural therapy (CBT)
2. Exposure and response preventions (ERP)
3. rTMS (repetitive transcranial magnetic stimulation)
4. Deep brain stimulation

Question 14

Is the 1st line non-pharmacological therapy to txt mild to moderate OCD with or without pharmacotheraphy?

Answer 14

CBT

Question 15

For how long the benefits of CBT remains?

Answer 15

1-5 yrs

Question 16

This non-pharmacological therapy is a specialized type of CBT for OCD and it is commonly practiced?

Answer 16

ERP

Question 17

This non-pharmacological therapy involves magentically stimulating certain areas of brain and can be considered in refractory OCD

Answer 17

rTMS

Question 18

This non-pharmacological therapy involves in insertion of a small neurostimulator into a targeted brain area and can be considered in refractory OCD?

Answer 18

Deep brain simulation

Question 19

This is the 1st line pharmacological therapy to treat OCD?

Answer 19

SSRIs

Question 20

What are the some examples of SSRIs:

Answer 20

Escitalopram
Fluoxetine
Fluvoxamine
Paroxetine
sertraline

Question 21

This is the 2nd line pharmacological therapy to treat OCD?

Answer 21

Citalopram
venlafaxine
clomipramine
mirtazapine

Question 22

These drugs can be more effective than SSRIs for comorbid pain/comorbid major depressive disorder:

Answer 22

Clomipramine and venlafaxine

Question 23

This drug has similar effectiveness to SSRIs in OCD but has lower tolerability due to anticholinergic and antihistaminic effects. ANd it should be taken with food

Answer 23

Clomipramine

Question 24

This drug causes significant weight gain but has lowr risk of sexual dysfunction

Answer 24

mirtazapine

Question 25

What are the 1st line pharmacological AUGMENTATIVE txt options?

Answer 25

SGAa as augmentative

Question 26

Examples of SGAs

Answer 26

Aripiprazole | risperidone

Question 27

2nd line pharmacological AUGMENTATIVE txt options?

Answer 27

Memantine Quetiapine topiramate

Question 28

3rd line of pharmacological AUGMENTATIVE txt options?

Answer 28

``` Olanzapine amisulpride ziprasidone haloperidol mirtazzapine celecoxib granisetron IV ketamine ondansetron N-acetylcysteine riluzole lamotrigine ```

Question 29

Natural health products to treat OCD?

Answer 29

Milk thistle Valerian root St.John's wort

Question 30

This natural health product to treat OCD can cause serotonergic activity and may cause serotonin syndrome when administered with other SSRIs?

Answer 30

St.John's wort

Question 31

This drug is linked with fetal cardiovascular malformations

Answer 31

paroxetine

Question 32

Recommended txt for OCD in preganancy, breastfeeding and pediatric pts?

Answer 32

CBT is 1st line

Question 33

Recommended txt for OCD in preganancy if symptoms are severe?

Answer 33

SSRIs