Morphine helps ease OCD

A weekly dose of oral morphine may help in easing symptoms of obsessive-compulsive disorder (OCD) in people who haven't benefited from standard drug treatments. The newer class of antidepressants known as serotonin reuptake inhibitor (SRIs) are approved for treating OCD, but up to 40 per cent of patients fail to respond to these drugs. Why morphine can be effective is not known, but other studies have suggested a role for drugs that interact with opioid receptors because there is a high concentration of opioid receptors in an area of the brain thought to be involved in OCD. The researchers enrolled 23 subjects with OCD who had tried different SRIs. The participants were assigned to a weekly oral morphine, the anti-anxiety drug lorazepam, or an inactive placebo, in random order for two weeks each. Average scores on a standard OCD scale declined from 29 to 25 while the subjects were taking morphine, and to 27 in the lorazepam phase. Seven of the 23 subjects were deemed to be responders to morphine based on score decreases of 25 percent or more. There were four subjects who responded to lorazepam. Among those responding to morphine, the most noticeable effect began the day after taking the drug and lasted for two to five days. These individuals reported decreased frequency and persistence of obsessions and anxiety, as well as an increased ability to resist their compulsions. There were no euphoric effects from taking the drugs although one subject later admitted to having abused hydrocodone for several years. The rapidity and the relative tolerability of the treatment are encouraging and warrant larger and longer-term studies of morphine or other opiate drugs for treatment-resistant OCD.