Biological Approach to treating OCD

Question 1

What level of serotonin is associated with depression and OCD?

Answer 1

Low

Question 2

What are the most common antidepressant and how do they work?

Answer 2

SSRI’s
- Serotonin released into synapse
- Targets receptor cells on receiving neuron
- Re-absorbed by initial neuron but inhibited so levels increase at synapse

Question 3

What is the antidepressant used after SSRI’s and how do they work?

Answer 3

Tricyclic
- Block the transporter that re-absorbs serotonin and noradrenaline
- Therefore more neurotransmitters are left in synapse prolonging their activity

Question 4

Why are tricyclics used after SSRI’s?

Answer 4

Have more side effects so used when SSRI’s are not effective

Question 5

What are common anti anxiety drugs?

Answer 5

Benzodiazapines

Question 6

What do anti anxiety drugs do?

Answer 6

• Slow down CNS by enhancing GABA

Question 7

What does GABA do and process?

Answer 7

General quietening effect on many neurons in the brain
- Reacts with GABA receptors on outside of receiving neurons
- Opens a channel that increases flow of chloride ion

Question 8

What do chloride ions do?

Answer 8

Make it harder for the neuron to be stimulated by other neurotransmitters so slow activity = more relaxed

Question 9

AO3 - Effectiveness

Answer 9

P - Research support for the use in treating symptoms of OCD
E - Soomro (2008) found in 17 studies, SSRI’s were more effective than placebos in short term
E - Shows it is appropriate in treating OCD
CA - Insufficient evidence for long term effectiveness Kooran (2007)
L - Support through studies so more research needed for long term impacts for OCD

Question 10

AO3 - Preferred over other therapies

Answer 10

P - One advantage is they are more convenient than other therapies/treatments
E - Little effort is required, less monitoring and cheaper
CA - However they also benefit from talking to GP about symptoms and also treatments
E - More viable for drugs to be the primary treatment as more comfortable than speaking as it can lead to restricted patients
L - Studies show drug treatments should not be first call for instance Kooran says CBT should be first

Question 11

AO3 - Side Effects

Answer 11

P - Numerous side effects
E - BZ’s can be aggressive and long term impairment of memory
- Tricyclics include hallucinations and therefore only used when SSRI not effective
- Soomro (2008) stated side effects of SSRI are headaches and nausea
E - Limitation as can interfere with daily routines due to severity so doctors will have to weigh up side effects before handing out drugs
L - Could start with prescribing SSRI which have least side effects and if they persist try the next level

Question 12

AO3 - Short term relief

Answer 12

P - Drugs are not a permanent solution
E - Koran (2007( in a comprehensive review suggests CBT should be used before drugs in terms of OCD
E - Drugs may be little effort but do not provide a long term cure indicated that many relapse within a few weeks after medication stops
L - Suggests other treatments should be used