Delayed- Maturation Theory of Obsessive Compulsive Disorder
Drug treatment of OCD may be assumed to affect a proposed functional imbalance between the frontal lobes and other parts of the brain. Serotonin reuptake inhibitors, SRI, especially potent ones given at high doses over long periods of time, are often effective in the treatment of obsessive-compulsive disorder. However, a large percentage of patients do not respond to treatment with the SRI, and those who do respond often do not fully remit, which should be the standard goal of treatment in OCD. If a patient has been treated for several months and has not yet responded to treatment with several types of SRI medication, the physician should perform a careful assessment of resistant and/or residual clinical symptoms. Any comorbid conditions to determine which next-step treatment would be the most appropriate. One strategy for patients who have not responded to treatment with a SRI is to switch them to aserotonin-norepinephrine reuptake inhibitors.
Sexual desire
Certain medications can cause changes in the level of experienced sexual desire through “non-specific effects on general well-being, energy level, and mood”. Declining levels of sexual desire have been linked to the use of anti-hypertension medication and many psychiatric medications; such as anti-psychotic medications, tricyclic anti-depressants, monoamine-oxidase (MAO) inhibitors, and sedative drugs. However, the most severe decreases in sexual desire relating to psychiatric medication occur due to the use of selective serotonin reuptake inhibitors (SSRIs). In women specifically, the use of anticoagulants, cardiovascular medications, medications to control cholesterol, and medications for hypertension contributed to low levels of desire. However, in men, only the use of anticoagulants and medications for hypertension was related to low levels of desire. In addition to the specific type of medication being used, the amount of medications used regularly was also found to be correlated with a lowering of sexual desire. One medication that many do not realize can lower sexual desire in women is the oral contraceptive. Not every woman experiences the negative side effects of the pill, however, as many as one in four do. In addition, the pill reduces the sexual attractiveness of women by changing their estrus phase. Oral contraceptives have been known to increase the levels of sex hormone-binding globulin (SHBG) in the body. In turn, high SHBG levels have been associated with a decline in sexual desire. Though it is not used as medication, the drug methamphetamine has a strong positive effect on many aspects of sexual behaviour, including sexual desire.