At what dosages are these drugs used?

OCD Ireland has found the following information the most comprehensive and up-to-date.

As a general rule, it appears that for most people high dosages of these drugs are required to obtain anti-obsessional effects. The studies done to date suggest that the following dosages may be necessary:

Faverin(up to 300 mg/day)
Prozac(40-80 mg/day)
Lustral(up to 200 mg/day)
Seroxat(40-60 mg/day)
Cipramil(up to 60 mg/day)*
Anafranil(up to 250 mg/day)

Where a lower dosage was listed, at least some of the studies have suggested that a dose lower than the minimum was not significantly better than placebo. I have also seen a very small number of patients who have not responded to large dosages of these medications, but who improved on extremely low doses, such as 5-10 mg/day of Prozac or 25 mg/day of Anafranil. These patients have not been carefully studied and, to my knowledge, these low-dosage responders are not reported in the psychiatric literature. If patients fail to improve with high dosages of the above medications, it is probably worth a trial of a very low dose.

Newer SRIs

Effexor (venflaxine), though not licensed for OCD, is being used by some European practitioners as a treatment on its own or in conjunction with another of the above listed medications. Dosages between 150mg- 300mg are needed. Effexor is selective serotonin norepenepherine re uptake inhibiter (SNRI) and bicyclic anti-depressant because it acts on both the norepinepherine & serotonin systems.

Sevincok L, Uygur B.
Aust N Z J Psychiatry. 2002 Dec;36(6):817.

*Information regarding Cipramil

(The following information has been obtained from: Forest Laboratories/Lundbeck 2003)

Forest Laboratories/Lundbeck does not make any claims to the effectiveness or safety of using Cirpamil to treat OCD as this medication is not indicated by the FDA to treat any OCD condition.

Furthermore Forest Laboratories/Lundbeck have released a newer drug Lexapro (escitalopram), a selective serotonin reuptake inhibitor (SSRI) used for the treatment of depression and other related problems. It is the active isomer of the antidepressant drug Cipramil (citalopram). It is regarded as faster acting and having fewer side effects.

"Cipramil consists of molecules with mirrored halves. Only the left-hand side is believed to enhance brain serotonin levels; the right side is thought to be inactive or perhaps linked to some side effects. Lexapro is Cipramil cut in half to get the presumed good side".
Forest vice president, Dr. Lawrence Olanoff.

"In a 491-patient study, 10 milligrams of Lexapro once a day worked as well as 40 mg of Cipramil. A few patients felt better about a week sooner than Cipramil users."
Lauran Neergaard of Boston.com

The information is sourced from an article written by :
Michael A. Jenike, M.D.
Professor of Psychiatry, Harvard Medical School,
Chairman, OC Foundation Scientific Advisory Board,
jenike@psych.mgh.harvard.edu

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