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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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Does the use of Guanfacine counteract the therapeutic effect

Customer Question

Does the use of Guanfacine for ADHD counteract the therapeutic effect of Clomipramine, Paxil or Zoloft used for OCD?
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello Welcome to JA

I am a board certified neurologist and will try to answer your question

Customer: replied 1 year ago.
Does it?
Expert:  Dr. Frank replied 1 year ago.

There is a serious interaction between guaifenesin and clomipramine. Using them in combination will tend to increase the blood levels of each by competitive inhibition for enzymatic induced metabolism in the liver. So excessive sedation maybe seen

I assume it would be Paxil or Zoloft as your SSRI for treatment in OCD, rather than both.

No interactions were seen between guaifenesin and either sertraline or Paxil.

I hope that answers your questions Dr Frank

Customer: replied 1 year ago.
Is Zoloft effective for OCD with less weight gain than Paxil?
Expert:  Dr. Frank replied 1 year ago.

Both are effective for OCD, Zoloft in my opinion is more sedating than Paxil as it is more "serotonergic" generally, but that action seems to reduce dopamine in areas of the medial forebrain.

I needed to check on weight gain, again my suspicion would be Zoloft more weight gain than Prozac or paxil. hang on I will check the literature

Expert:  Dr. Frank replied 1 year ago.

http://www.ncbi.nlm.nih.gov/pubmed/25467076

not much in the literature comparing the weight gain between these two drugs, they are both known to do it. It is hard to do a study like that as there are too many variables

Fluoxetine or Prozac is one SSRI for OCD which is supposedly not tied to weight gain, so that might be an idea rather than the other two.

I hope that helps Dr Frank

Customer: replied 1 year ago.
Thanks a lot
Customer: replied 1 year ago.
What is the effect of dopamine reduction in the medial forebrain caused by Zoloft?
Expert:  Dr. Frank replied 1 year ago.

Please get back to me on the proposed additional time if I can help. Please remember to rate my service as that is how I am paid for my answers. Dr frank

Expert:  Dr. Frank replied 1 year ago.

If you would like to discuss this topic further, please feel free to use the reply box and let me know. If you are satisfied with my assistance, please take a moment to use the stars at the top of the page to rate my answer so that I will be compensated for helping you today. For future questions,you can find me here : http://www.justanswer.com/medical/expert-neuromd2012/ ( Please book mark it) Thank you so much, Dr. Frank