lesson 13 drug therapy and OCD

Question 1

Anti-depressants ao1

Answer 1

-selective serotonin re-uptake inhibitors (SSRI) examples include Prozac and Fluoxetine, prescribed for 12-16 weeks
-low levels of serotonin are associated with ocd and depression
-ssri drugs aim to prevent the reuptake of serotonin and prolong its activity in the synapse, means the person will feel less anxious and have a higher level of serotonin available
-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 given to ocd patients will increase serotonin levels and help to regulate mood and reduce anxiety levels, will also help normalise and reudce ‘worry circuit’, serotonin becomes readily available in receptor cells so that high levels can cause an increase in mood
-high levels of serotonin provided by ssri drugs help the orbital frontal cortex to function at normal levels, orbital frontal cortex has extensive connections with sensory ares and the limbic system which is involved in emotion and memory, ssri drugs will help stabilise moods and emotions and improve memory, therefore reducing compulsvie behaviours
-SNRI (selective norepinephrine reuptake inhibitors) are a new type of drug that increase serotonin and noradrenaline/norepinephrine, drugs are suitable for ocd patients that cannot tolerate ssri drugs
-norepinephrine/noradrenaline is a neurotransmitter released from the sympathetic nervous system in response to stress, aims to mobilise the brain and body for action, act on the reuptake of noradrenaline/norepinephrine

Question 2

anti-depressants ao3

Answer 2

-Soomro (2009) reviewed 17 studies that compared ssri to placebo drugs for treating ocd and found that all 17 studies showed that ssri drugs were more effective that placebos especially when combined with cbt
-relatively effective and 70% of patients have experienced a decline in ocd symptoms, however the remaining 30% of patients tend to opt for psychological therapies or a combination of ssri and therapies, which meant maybe ssri are most effective if combined with other treatments
-relatively cheap and cost effective in comparison to psychological therapies, good value for money for the NHS and is economical comparef to other treatments
-do not work for all ocd patients, might not alleviate all patients symptoms and have to take alternative drugs which are more effective for them
-terrible side effects which means the patient may stop taking the medication, temporary but include indigestion, blurred vision and loss of sex drive
-Koran (2007) stated that drug therapy might be a common/popular treatment but psychotherapies such as cbt should be tried first to help reduce ocd symptoms, drug therapy requires little effort and may be effective short term but it does not provide a lasting cure and many patients relapse within a few weeks if the medication is stopped

Question 3

Benzodiazepines ao1

Answer 3

-help to reduce anxiety and aim to control the action of neurotransmitters, examples include Vallum and Xanax
-reduce the activity in the central nervous system and reduce brain arousal, aim to reduce blood pressure and heart rate
-aims to increase gamma-amino butyric acid (GABA), neurotransmitter in the brain that slows down the firing of neurons and makes the person less anxious and calmer, helps to reduce the psychological actiivty in the body
-bz drugs bind to the GABA receptor site of the post synaptic neuron, increases the flow of chloride ions into the post synaptic neuron, chloride ions make it more diofficult for the neuron to be stimulated by other neurotransmitters, thus slowing down its activity and making the person feel more relaxed, neurons in the brain become less active and the person feels calmer
-bz help to reduce the anxiety that an ocd patient might experience when they are having their obsessional thoughts, also decreases serotonin levels in the brain, means the person has lower arousal and reduces anxiety but are more likely to get depressed

Question 4

benzodiazepines ao3

Answer 4

-very effective at reducing symptoms, used by millions worldwide so very good on global basis
-work very quickly and effectively compared to other treatments like cbt, act in a short period of time so patient will see immediate benefits of relief
-can be used for short periods of time and produce hardly any real serious side effects unlike other types of drugs
-if used long term several unwanted side effects can begin to appear such as drowsiness, depression, unpredictable interactions with alcohol, patients have a high chance of being involved in accidents
-Ashton 1997 found long term users of the drug became very dependent on the drug and sudden withdrawal leads to return of high levels of anxiety and ocd symptoms, problem of tolerance/drug escalation whereby patients need to take very large doses of drug in order to reduce ocd symptoms if they take for a long period of time
-Stewart 2005 criticsed long term use of bz drugs as cause impairment in speed and processing of verbal learning, effects are temporary but still negative, carried out meta analysis and found clear evidence that long term use of bz leads to cognitive impairments, cognitive ability seems to improve once bz drugs are withdrawn but cognitive ability is still below that of control patients who have never taken bz