NSAID (COX-1 and COX-2 inhibitor, antiinflammatory)

  • OCD3

Dosing

250mg bid as augmentation to SSRI in OCD

Management

Supported by one RCT in OCD and theoretical basis of inflammation in OCD.

TOLERABILITY: No problems.

RISKS: Gastric ulcer, thrombosis (heart attacks, stroke), hypertension, heart failure, hepatotoxicity (1%), renal toxicity, asthma, hepatitis, and anemia (0.2%) Avoid if allergies to sulfa or aspirin (can cause Stevens-Johnson Syndrome, anaphylaxis, and asthma). Avoid in pregnancy.

Main risks are long-term so best to give for 6 months to get them better and then try to stop.

EMR Text

OCD

Naproxyn use based on a randomized controlled trial in OCD (Shamabadi A et al, Psychiatry Clin Neurosci. 2024;78(12):810-817).

Naproxyn’s risks, including ulcer, thrombosis, cardiac, liver, kidneys, and anemia, reviewed with patient.

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