Biological Approach to Treating OCD

Question 1

Intro

Answer 1

• Research showing OCD is mainly biologically based suggets biological treatments would be successful in treating OCD
• Drug therapies target abnormal neurotransmitter levels

Question 2

What are SSRIs?

Answer 2

• Selective Seratonin Reuptake Inhibitors e.g. prozac (fluoxetine)
• As OCD is due to low seratonin levels SSRIs are use to increase the level of seratonin in the synapse
• This regulates mood and decreases anxiety caused by OCD
• They work by blocking reuptake of seratonin back into the pre-synaptic neurone, leaving more in the synapse
• Thus there’s more seratonin to influence activity of the post-synaptic neurone which prolongs activation of seratonin and makes transmission of inhibition signals to the next neuron easier
• This addresses the low levels of seratonin in the synapse
• SSRIs take around 3-4 months of daily use to impact symptoms much

Question 3

What are tricyclics?

Answer 3

• Tricyclics are a SRI (Seratonin Reuptake Inhibitors)
• They work in the same way as SSRIs but are less selective in their action
• They block the mechanism of reuptake of seratonin and noradrenaline into the pre-synaptic neurone
• This leaves more neurotransmitters in the synapse thus prolonging activity of seratonin and noradrenaline on receptor sites in the post-synaptic neurone. This makes transmission to the next neuron easier
• Tricyclics are used when SSRIs are not effective

Question 4

How does Soomro support?

Answer 4

• A strength of the BA is that there is evidence supporting SSRIs being effective in treating OCD
• Soomro reviewed 17 studies on the use of SSRIs to treat OCD and found that for 70% of people SSRIs were more effective than a placebo in reducing OCD symptoms up to 3 months after treatment
• The remaining 30% needed a combination of drug and psychological treatments
• This shows that SSRIs are effective as most of those who took them recovered from OCD
• This also shows that SSRIs are a flexible treatment that can be used with psychological treatments to have a lasting impact on OCD symptoms

Question 5

How does Simpson weaken the treatment?

Answer 5

• A weakness of drugs is that they are not a lasting cure
• Simpson et al ound that 45% of patients on clomipramine (an SRI) relapsed back into OCD behaviour within 12 weeks after finishing their drug course
• This relapse rate was higher than those who went though psychological therapy (12%)
• This shows that drugs don’t cure OCD as they only temporarily treat the symptoms of OCD and that psychological therapies is more effective in the long term
• This reduces the effectiveness of biological treatments

Question 6

How is side effects a weakness?

Answer 6

• A weakness of drug therapy is that there are side effects
• Soomro found that common side effects include nausea, headache, insomina, loss of libido
• Tricyclic drugs like clomipramine have even more serious side effects like hallucination, weight gain, and irregular heart beat
• This reduces the effectiveness of SSRIs as people may stop taking them due to the side effects
• This also reduces the appropriateness of SSRIs compared to psychological treatments as people with existing heart or sleep conditions cannot take drug therapy

Question 7

What is another strength?

Answer 7

• Another strength is that it’s non-disruptive to the patient’s life as it requires little time and effort compared to CBT where patients have to attend regular appointments and do homework
• This means that patients (who don’t suffer from side effects) are less likely to drop out as they are not put off from sticking to the treatment and completing it
• Also, drugs are good value for health service providers like NHS as they are cheaper than psychological treatments and don’t require a therapist to adminster treatment
• As drugs are easily dispensable and cost effective they increase in appropriateness for organisations like NHS