Exploring the use of medication for treating hoarding disorder.
Let me start by saying that people often don't seek treatment for hoarding disorder. It's usually another issue like depression, obsessive compulsive disorder or anxiety that they look to alleviate. While a mental health professional evaluates the client and their presenting problems, other questions are asked which may trigger the red flag for hoarding behaviors.
To date, there are currently no medications approved by the Food and Drug Administration (FDA) to treat hoarding disorder. What is found to be somewhat helpful are drugs like SSRIs - selective serotonin reuptake inhibitors - which are anti-depressants that treat anxiety and depression. These medications have also been useful in treating Obsessive Compulsive Disorder (OCD) which is a related disorder to Hoarding Disorder (HD).
There have been two studies done which examined medications used for people diagnosed with HD without OCD. The fist study involved using the medication Paxil (Paroxetine, an SSRI) which showed that both HD and non-HD patients had similar outcomes, with half of each group showing at least partial benefit.
The second study involved the medication Effexor (Venlafaxine, an SNRI - serotonine-norepinephrine reuptake inhibitor). This study showed that HD symptoms decreased by 32% and that 70% of those in the study had a very good response rate.
Because of the limited research on medications and hoarding, the school of thought is to treat HD with an SSRI that treats OCD and monitor its effect. If no change is noted for 12-weeks at the highest dosage then adding one of the following may be helpful: Risperdal*, Zyprexa*, Seroquel* or Haldol*.
According to the International OCD Foundation (IOCDF), another viewpoint is that people with HD often struggle with the same issues as people with Alzheimer's: information-processing, decision-making, organization, attention, and memory. Medications to target these challenges would include: Aricept* and Reminyl*.
*Note that these are trademarked and common brand names of medications.
Lastly, stimulant medications that target Attention Deficit Hyperactivity Disorder (ADHD) might prove useful for HD patients as they improve alertness and attention.
Please note that as a Licensed Clinical Social Worker (LCSW) I am qualified to diagnose Hoarding Disorder and provide counseling treatment, but I am not qualified to prescribe medications. You would need to seek out your physician or psychiatrist to have them prescribe any medicines.
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