Biological approach: Treating OCD Flashcards
Drug therapy
Biological approach: Treating OCD
Aims to increase/decrease levels of neurotransmitters in brain or increase/decrease their activity
Low levels of serotonin are associated w/ OCD
So drugs to treat OCS work to increase levels of serotonin in brain
SSRIs
Biological approach: Treating OCD
Work on serotonin system in brain
Serotonin is released by presynaptic neurons & travels across a synapse
Serotonin chemically conveys signal from presynaptic to post synaptic neuron & then is reabsorded by presynaptic where it is broken down & reused
By preventing reabsorption & breakdown, SSRIs increase levels of serotonin in synapse & thus continue to stimulate postsynaptic neuron
This compensates for whatever is wrong w/ serotonin system in OCD
Dosage & other advice vary according to which SSRI is prescribed
Typical daily does of fluoxetine is 20mg although this may be increased if not beneficial
Drug is avaliable as capsules or liquids
Takes 3-4 months of daily use to have impact on symptoms
Combining SSRIs w/ other treatments
Biological approach: Treating OCD
Drugs often used alongside CBT to treat OCD
Drugs reduce person’s emotional symptoms which means people w/ OCD can engage more effectively w/ CBT
In practise some people respond best to CBT alone whilst others benefit more when additionally using drugs like fluoxetine
Occasionally other drugs are prescribed alongside SSRIs
Alternatives to SSRIs
Biological approach: Treating OCD
When SSRI is not effective after 3-4 months, dose can be increased or it can be combined w/ other drugs
Sometimes diff antidepps are tried
Tricyclics (such as clomipramine) acts on various systems including serotonin systems where it has same effect as SSRIs
Clomipramine has more severe side-effects than SSRIs so is generally kept in reserve for people who don’t repond to SSRIs
SNRIs are a diff class of antidepps & are 2nd line of defense for people who don’t respond to SSRIS
SNRIs increase levels of serotonin & noradrenaline
Evaluation: Evidence for effectiveness
Biological approach: Treating OCD
Strength: evidence for effectiveness
Clear evidence to show SSRIs reduce symptom severity & improve quality of life for people w/ OCD
Soomro et al reviewed 17 studies that compared SSRIs to placebos in treatment of OCD
ALl 17 studies showed sigly better outcomes for SSRIs than for placebo conditions
Typically symptoms reduce reduce for around 70% of people taking SSRIs
For remaning 30%, most can be helped by either alternative drugs or combos of drugs & psycholgical therapies
Therefore, drugs appear to be helpful for most people w/ OCD
Evaluation: Evidence of effectiveness (Counterpoint)
Explanations for forgetting: Interference
However, while drug treatments are helpful, they may not be most effective treatment for OCD
Skapinakis et al carried out systematic review of outcome studies & concluded that both cog & behavioural therapies were more effective than SSRIs in treatment of OCD
Therefore, drugs may not be optimum treatment for OCD
Evaluation: Cost-effective & non-disruptive
Explanations for forgetting: Interference
Strength: drugs are cost-effective & non-disruptive to people’s lives
Drug treatments are cheap compared to psychological treatments as many thousands of tablets can be manufactured in time it takes to conduct one session of psychological therapy
Using drugs to treat OCD is therefore good value for public health systems like NHS & represents good use of limited funds
As compared to psychological therapies, SSRIs are non-disruptive to people’s lives
If you wish you can simply takes drugs until symptoms decline
Diff from psychological therapy which involves time spent attending therapy sessions
Therefore, drusg are popular w/ many people w/ OCD & their doctors
Evaluation: Serious side-effects
Explanations for forgetting: Interference
Limit: potentially serious side effects
Drugs such as SSRIs help most people, small minority will get no benefits
Some people experience side-effects such as indigestion, blurred vision & loss of sex drive
These side-effects are usually temporary but can be quite distressting for people & for a minority they are long-lasting
For those taking clomipramine, side effects are more common & can be more serious
E.g. 1 in 10 people experience erection problems & weight gain, 1 in 100 become aggressive & experience heart-related problems
Therefore, people gave reduced quality of life as result of taking drugs & may stop taking them altogether, meaning drugs cease to be effective
