biological approach to treating OCD

Question 1

what does drug therapy aim to do

Answer 1

increase/decrease levels of neurotransmitters in the brain or increase/decrease their activity

Question 2

how do drugs used to treat OCD work

Answer 2

aim to increase level of seretonin in brain

Question 3

3 ways to treat OCD using drug therapy

Answer 3

1. SSRIs
2. combining SSRIs with other treatments
3. alternatives to SSRIs

Question 4

how are SSRIs used to treat OCD

Answer 4

• antidepressant drug = ‘selective seretonin reuptake inhibitor’
• prevent reabsorption & breakdown (by presynaptic neurone) of seretonin
• increase levels of seretonin in synapse & thus, continue to stimulate post-synaptic neurone
• dosage & other advice vary according to the SSRI prescribed (eg. typical daily dose of fluoxetine is 20mg but may increase if not benefitting person)
• available as capsules or liquid
• takes 3-4 months of daily use for SSRIs to begin working

Question 5

what are SSRIs often used alongside

Answer 5

= cognitive behaviour therapy (CBT)
- drugs reduce persons emotional symptoms, so they can engage better with CBT
- occasionally other drugs used alongside SSRIs

Question 6

what happens if SSRIs aren’t effective after 3-4 months

Answer 6

• dose increased (eg. up to 60mg per day for fluoxetine)
  or
• combined with other drugs

Question 7

2 alternatives to SSRIs

Answer 7

1. tricyclics (older antidepressant)
   - eg. clomipramine
   - acts on various systems, including seretonin system, where it has same effect as SSRIs
   - clomipramine has more severe side effects than SSRIs so kept for those who don’t respond to SSRIs
2. SNRIs (seretonin-noradrenaline reuptake inhibitors)
   - different class of antidepressant drug
   - second line of defence for those who don’t respond to SSRIs
   - increase levels of seretonin & noradrenaline

Question 8

AO3 +) evidence for drug therapies effectiveness in treating OCD

Answer 8

E:
- evidence showing SSRIs reduce symptom severity & improve quality of life for those with OCD
- soomro et al. (2009) reviewed 17 studies comparing SSRIs to placebos & all studies showed significantly better outcomes for SSRIs
- typically, symptoms reduce around 70% when taking SSRIs
- the other 30% can be treated by alternative drugs or combination of drugs & psychological therapies

T: means drugs appear helpful for most people with OCD

Question 9

counterpoint AO3 -) evidence suggesting drug treatments may not be most effective treatments available for OCD

Answer 9

E:
- skapinakis et al. (2016) carried out systematic review of outcome studies & concluded cognitive/behavioural therapies were more effective than SSRIs

T: means drugs may not be optimum treatment for OCD

Question 10

AO3 +) drug therapies are cost-effective & non-disruptive to people’s lives

Answer 10

E:
- cheap compared to psychological treatments as many thousands of tablets/liquid doses are manufactured in time taken to conduct 1 session of psychological therapy
- using drugs when treating OCD is good value for public health systems (eg. NHS) & is good use of limited funds
- SSRIs are non-disruptive to peoples lives compared to psychological therapies (time spent attending sessions)

T: means drugs are popular with people with OCD & doctors

Question 11

AO3 -) drugs have potentially serious side effects

Answer 11

E:
- small minority will not benefit from drugs (eg. SSRIs)
- some also experience side effects (eg. indigestion, blurred vision)
- side effects are usually temporary but can be distressing & for some are long-lasting
- the tricyclic clomipramine has common side effects which can be serious

T: means some people have reduced quality of life due to taking these drugs, & may stop them taking them altogether, meaning drugs aren’t effective