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University of Cincinnati Academic Health Center
Publish Date: 07/09/02
Media Contact: AHC Public Relations, (513) 558-4553
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UC Researchers Awarded United States Patent

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.

Approximately 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.

While 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 24 hours.

"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 their lives."

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.

"There 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."

Since 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.

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