Bio Treatmenst Flashcards
What types of medications are used for biological treatments of obsessive-compulsive disorder?
SSRIs, tricyclics, monoamine oxidase inhibitors (MAOIs)
These medications are designed to increase monoamine neurotransmitters.
How are most medications for OCD administered?
Orally as tablets
This is the common method for administering biological treatments for OCD.
What is the typical time lag for noticing improvement with antidepressants for OCD?
Up to 12 weeks
Patients usually do not notice any improvement initially.
How long do people generally need to stay on medication to prevent relapse?
At least one year
This duration is necessary to effectively manage OCD symptoms.
What may be necessary as an alternative to ceasing medication completely?
A maintenance dose
This helps in managing symptoms without stopping medication abruptly.
Why is it important to manage the dosage of OCD medications carefully?
To prevent unpleasant withdrawal symptoms
Some drugs can lead to withdrawal if ceased too quickly.
What neurotransmitters do tricyclics increase?
Serotonin, dopamine, noradrenaline
These neurotransmitters play a role in mood regulation.
What was the name of the tricyclic drug prescribed to Charles in the case study?
Clomipramine
This drug had a significant impact on Charles’s daily functioning.
How quickly did clomipramine impact Charles’s daily functioning?
Within just four weeks
This allowed him to perform tasks he previously could not due to OCD.
What symptom was Charles struggling with that affected his daily activities?
Obsession with stickiness
He perceived stickiness as a ‘disease’.
What happened to Charles’s response to clomipramine over time?
He built up a tolerance
This led to the drug no longer being effective for him.
How did Charles’s OCD symptoms manifest after building a tolerance to the drug?
Symptoms returned in a more manageable way
This allowed him to function relatively well during the school day.
What do SSRIs do in the synapse?
SSRIs increase serotonin in the synapse by blocking presynaptic transporter molecules.
Is the exact mode of action for SSRIs clear?
No, the exact mode of action for these drugs is still unclear.
What happens to symptoms when SSRIs are used?
Improvement in symptoms is often not observed for some considerable time.
What might cause the improvement in symptoms after using SSRIs?
Improvement may result from down regulation, where the brain compensates for increased serotonin.
How might serotonin levels affect other neurochemicals?
Serotonin levels may regulate the release of other neurochemicals, triggering a reduction in symptoms.
What is one way to enhance the effects of SSRIs in treatment-resistant patients?
By offering additional drugs, such as risperidone (an atypical antipsychotic).
What percentage of patients showed clinical effectiveness with SSRIs and risperidone?
72 per cent of patients showed clinical effectiveness.
What reduction in Y-BOCS scores indicates effectiveness of the SSRI and risperidone combination?
A reduction of at least 35 per cent in Y-BOCS scores.
What is granisetron?
Granisetron is a serotonin antagonist that blocks serotonin receptors.
What combination achieved a 100 per cent effectiveness?
A combination of an SSRI and granisetron.
Fill in the blank: SSRIs increase serotonin in the synapse by blocking _______ molecules.
presynaptic transporter
What was the success rate in the study by Askari et al. (2012)?
100 cent success rate
The specific percentage is not provided in the text, but it indicates a high level of success.
By what percentage did all patients improve on the Y-BOCS?
35 per cent
Y-BOCS stands for Yale-Brown Obsessive Compulsive Scale, a measure used to assess the severity of obsessive-compulsive disorder.
What percentage of patients were symptom-free after two months?
90 per cent
Indicates a significant positive outcome from the biological treatments administered.
What do the results of the study demonstrate about biological treatments?
They can have a remarkable impact if the correct combinations can be found
Highlights the importance of personalized treatment approaches.
What must be put in place to support individuals undergoing biological treatments?
Measures to support the individual with potential side effects
Addresses the need for monitoring and managing side effects during treatment.
What is a strength of SSRIs in treating OCD?
Their use is supported by research evidence indicating that the impact is not simply a placebo effect.
For example, a meta-analysis of 17 randomized control trials found significantly greater improvement in patients’ symptoms in treatment groups compared to placebo.
What did Issari et al. (2016) find regarding SSRIs?
They found that the amount of relief provided by SSRIs appeared to diminish over time, but this was moderated by offering higher dosages.
What is a practical weakness of SSRIs?
They can lead to unpleasant side effects such as constipation, diarrhoea, nausea, vomiting, headaches, dizziness, anxiety, and sleep problems.
What issue can arise from the side effects of SSRIs?
They can lead to non-compliance, meaning people may not take their medication.
What percentage of people report no improvement in symptoms after standard drug treatments for OCD?
Up to 60 percent report no improvement.
(McDougle et al., 1993)
What is the typical reduction in symptom severity for those who do experience relief from SSRIs?
The reduction may only be between 20 and 30 percent.
(Pigott and Seay, 1999)
What does the polygenic nature of OCD imply for future treatments?
It suggests that medicine may become more personalized, allowing doctors to tailor treatments based on the unique combinations of genes influencing each patient’s symptoms.
What is critical to the success of biological treatments for OCD?
Situational factors, such as the quality of the therapeutic alliance between doctors and patients, impact the effectiveness of the treatment.
