OCD is a heterogeneous disorder that involves multiple asynchronous brain regions, with a net effect of reducing the influence of the neocortex (thinking brain) on emotional/motoric regions, which creates the redundancy seen in the illness. Different neurotransmitter systems have been implicated, including glutamate (the main excitatory neurotransmitter), serotonin, and dopamine.
SSRIs, anticonvulsants, and some atypical antipsychotics, such as risperidone at low doses, have shown efficacy in the treatment of OCD. The symptoms of the patient described at the beginning of this article improved significantly when low-dose risperidone and then adjunctive topiramate was added to his treatment regimen. Residual symptoms are currently being targeted with an SSRI.
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Cite this: Obsessive-Compulsive Disorder: Neurobiology and the Latest in Treatment - Medscape - May 17, 2017.