L13 Biological treatment for OCD Flashcards
How does the biological approach treat OCD ?
The biological approach uses medication to increase or decrease levels of
neurotransmitters, or the activity of neurotransmitters, in the brain.
The general purpose is to decrease anxiety, lower arousal, and lower blood
pressure and decrease heart rate.
What two anti-depressants drugs are used to treat OCD?
- BZ’S: Benzodiazepines
- SRRI’s: Selective serotonin reuptake inhibitors
Examples of SSRI’s
. Prozac and Fluoxetine
How do SSRI’s work ?
Serotonin is released by presynaptic neurons (brain cells) and travels
across the synaptic cleft (gap between neurons). It chemically conveys
the signal from the presynaptic neuron to the postsynaptic neuron and is
then reabsorbed (re-uptake) by the presynaptic neuron, where it is
broken down and reused.
SSRIs prevent the reabsorption and breakdown of serotonin and so
increase the level of serotonin in the synapse, where it continues to
stimulate the postsynaptic neuron. The effect of this should be to
reduce anxiety.
What is the worry circuit and how is it affected by OCD and then SSRI’S ?
Low levels of serotonin are implicated in the, “worry circuit” whereby damage to the caudate nucleus in the brain fails to suppress minor worry signals. A message is then sent to the orbital frontal cortex and the worrying and anxiety get worse.
· Therefore drugs are given to OCD patients that will increase serotonin levels and help to regulate mood and reduce anxiety levels.
· Increasing serotonin via SSRI drugs will also help to normalize and reduce the “worry circuit” and anxiety
Evaluation of SSRI’s (do not work for all patients)
SSRI’s can be criticised because they do not work for all OCD patients. For some patients SSRI drugs will not alleviate their OCD symptoms and they will have to take an alternative drug such as tricyclics instead which might be more effective for them
Evaluation of SSRI’s (terrible side effects)
A problem with SSRI drugs is that they have terrible side effects which might mean that the OCD patient might stop taking the medication. Side effects are temporary but include indigestion, blurred vision and loss of sex drive.
Evaluation of SSRI’s (cheaper compared to other treatments)
SSRI’s have the benefit of being relatively cheap and cost effective in comparison to psychological therapies, such as CBT, counselling or family therapy. Using SSRI drugs to treat OCD is good value for money for the NHS, and is economical compared to other treatments
Evaluation of SSRI’s (relatively effective)
An advantage of SSRI drugs is that they are relatively effective and 70% of patients have experienced a decline in OCD symptoms when taking them. However, the remaining 30% of patients tend to opt for psychological therapies or a combination of SSRI’s and psychological therapies for treating their OCD, which meant that maybe SSRI drugs are most effective if combined with other treatments too
Examples of BZ’s
Valium and Diazepam
What do BZ’s do ?
they slow down the activity of the
central nervous system by enhancing the activity of the
neurotransmitter GABA. This neurotransmitter has an inhibitory effect
on neurons, making the person more clam and less anxious
How do GABA neurotransmitters work?
GABA does this by reacting with special sites called GABA receptors on
the outside of neurons. When GABA locks into these receptors it opens
a channel that increases the flow of chloride ions into the neuron.
Chloride ions make it harder for the neuron to be stimulated by other
neurotransmitters, thus slowing down neural activity and making a person
feel more relaxed.
Evaluation of BZ drugs (side effects, long term)
However, if BZ drugs are used long term then several unwanted side effects can begin to appear, examples include drowsiness, depression and unpredictable interactions with alcohol. Patients have a high chance of being involved in accidents. Therefore BZ drugs should not be used as a long term treatment for OCD
Evaluation of BZ drugs (side effects short term)
BZ drugs can be used for short periods of time and they will produce hardly any real serious side effects unlike other types of drugs. Therefore side effects are kept to a minimum with BZ (in the short term) and this is a good point for the OCD patient
Evaluation of BZ drugs (speed)
BZ drugs work very quickly and effectively to cure OCD symptoms compared to other psychological treatments (such as CBT). BZ drugs can begin to reduce anxiety levels and OCD symptoms in a short period of time so that the patient will see some immediate benefits of relief.
