**L13 - Biological Treatments for Obsessive Compulsive Disorder

Question 1

what is the BIOLOGICAL APPROACH to TREATING OCD?

Answer 1

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, LOWER BLOOD PRESSURE and DECREASE HEART RATE

Question 2

what are SSRIs? - PT 1

Answer 2

One method of treating OBSESSIVE COMPULSIVE DISORDER is ANTI DEPRESSANT DRUGS called SELECTIVE SEROTONIN RE-UPTAKE INHIBITORS (SSRIs)

SSRIs (e.g PROZAC and FLUOXETINE) work on the SEROTONIN SYSTEM IN THE BRAIN

SEROTONIN is RELEASED BY PRESYNAPTIC NEURONES (brain cells) and TRAVELS ACROSS THE SYNAPTIC CLEFT (gap between neurones)

Question 3

what are SSRIs? - PT 2

Answer 3

It CHEMICALLY CONVEYS the SIGNAL FROM THE PRESYNAPTIC NEURONE to the POSTSYNAPTIC NEURONE and is then REABSORBED (re uptake) by the PRESYNAPTIC NEURONE, 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 NEURONE.

The effect of this should be to REDUCE ANXIETY

Question 4

+ SOOMRO (EVALUATION OF SSRIs)

Answer 4

+ SOOMRO REVIEWED 17 STUDIES that COMPARED SSRIs to PLACEBO DRUGS for TREATING OCD and found that ALL 17 STUDIES showed that SSRI DRUGS WERE MORE EFFECTIVE THAN PLACEBOS, especially when SSRIs were COMBINED WITH COGNITIVE BEHAVIOURAL THERAPY

Question 5

+ EFFECTIVE (EVALUATION OF SSRIs)

Answer 5

+ 70% OF PATIENTS have experienced a DECLINE IN OCD SYMPTOMS when TAKING SSRIs

The REMAINING 30% of patients tend to OPT FOR PSYCHOLOGICAL THERAPIES or a COMBINATION OF SSRIs and PSYCHOLOGICAL THERAPIES

Question 6

• SIDE EFFECTS (EVALUATION OF SSRIs)

Answer 6

• a problem with SSRIs is that they have SEVERE 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

Question 7

what are BENZODIAZEPINES? - PT 1

Answer 7

ANTI ANXIETY DRUGS, such as BENZODIAZEPINES (BZ), are COMMONLY USED TO TREAT OCD

BZs (e.g VALIUM and DIAZEPAM) SLOW DOWN the ACTIVITY of the CENTRAL NERVOUS SYSTEM by ENHANCING THE ACTIVITY OF THE NEUROTRANSMITTER GABA.

This neurotransmitter has an INHIBITORY EFFECT on NEURONES

Question 8

what are BENZODIAZEPINES? - PT 2

Answer 8

GABA does this by REACTING WITH SPECIAL SITES called GABA RECEPTORS on the OUTSIDE OF NEURONES

When GABA LOCKS INTO THESE RECEPTORS, it OPENS A CHANNEL that INCREASES THE FLOW of CHLORIDE IONS INTO THE NEURONE

CHLORIDE IONS make it HARDER FOR THE NEURONE TO BE STIMULATED by OTHER NEUROTRANSMITTERS, thus SLOWING DOWN NEURAL ACTIVITY and MAKING A PERSON FEEL MORE RELAXED

Question 9

+ IMMEDIATE RELIEF (EVALUATION OF BENZODIAZEPINES)

Answer 9

+ BZ DRUGS can begin to REDUCE ANXIETY LEVELS and OCD SYMPTOMS in a SHORT PERIOD OF TIME, especially when compared to OTHER TREATMENTS LIKE CBT, so that the patient can experience IMMEDIATE RELIEF

Question 10

• SIDE EFFECTS, ASHTON (EVALUATION OF BENZODIAZEPINES)

Answer 10

• 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

ASHTON found that LONG TERM USERS OF BZ became VERY DEPENDENT on the drug and a SUDDEN WITHDRAWAL of the drug leads to a RETURN OF HIGH LEVELS OF ANXIETY AND OCD SYMPTOMS

There is also the PROBLEM OF TOLERANCE whereby patients NEED TO TAKE LARGER and LARGER DOSES of the drug IN ORDER TO REDUCE THEIR OCD SYMPTOMS because their body HAS GOTTEN USED TO THE DRUG