Cincinnati-- The University of Cincinnati (UC) has been assigned a
United States patent for the use of the painkiller tramadol, also
called UltramŽ, for the treatment of obsessive compulsive disorder
(OCD) and related disorders, such as eating disorders, body dysmorphic
disorder, and Tourette's Syndrome. These related disorders have
numerous similarities and frequently coexist with OCD.
3.3 million Americans suffer from OCD in a given year. OCD is a chronic
and often disabling condition with symptoms ranging from depression to
irrational fears to compulsive checking, arranging and hoarding. Nearly
half of all people who suffer from this illness have limited benefit
from traditional psychiatric medications. Thanks to an initial
observation by Nathan Shapira, MD, a former resident of the UC
Department of Psychiatry, treatment may now come from a painkiller.
at UC, Dr. Shapira worked in the inpatient unit with Paul Keck, MD, the
attending psychiatrist at the time and current professor of psychiatry
and vice chair for research. Dr. Shapira was treating a patient who had
severe OCD and Tourette's syndrome, a neurological disorder related to
OCD, characterized by repeated involuntary movements and uncontrollable
vocal sounds called tics. The patient was treated with codeine, a
painkiller, which helped alleviate some of the tics but had no effect
on the OCD. The patient became tolerant to the drug and was give
tramadol instead. The patient's symptoms significantly decreased within
"In some patients, tramadol can even take affect and
decrease symptoms within 30 minutes to an hour," Dr. Shapira said.
"Traditional drugs used to treat these illnesses have to be taken for
at least 8-12 weeks before any response is apparent. This drug is
unique in that it can be taken on an as-needed basis and can have an
immediate response time."
As a result of this finding, Drs.
Shapira and Keck in conjunction with Toby Goldsmith, MD, a former
assistant professor of clinical psychiatry at UC, now a clinical
assistant professor of psychiatry at the University of Florida,
designed a small clinical trial to test the drug. Patients enrolled in
the study had no previous response to other treatments. The results of
the study were favorable.
"All the patients we have studied have
had anywhere from 25-65 percent relief from their symptoms," Dr.
Shapira said. "A moderate response that certainly was an improvement in
Dr. Shapira, currently an assistant professor of
psychiatry at the University of Florida, says tramadol is not a cure,
but is a step in the right direction. The drug is FDA-approved for use
as a pain killer, but further research needs to be done to get FDA
approval for its use to treat OCD and related disorders.
are a lot of people that do not experience substantial benefit from
treatments for OCD," he said. "With further research and clinical
trials, we will be able to find out more about this drug and how it
works and develop even better treatments for this illness."
tramadol is a mild opiate, there is some risk of addiction. However,
Dr. Shapira says the drug has a low physical dependence and abuse level
and is mild enough that its benefits for people who are disabled by OCD
often outweigh the negatives.