Lesson 13 - OCD: Biological Approach To Treating OCD (Drug Therapy) Flashcards
Ao1: anti-depressants SSRI drugs
• Selective Serotonin Re-uptake Inhibitors examples include Prozac and Fluoxetine
• 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: person will feel less anxious and have a higher level of serotonin available
• Low levels of serotonin are implicated in the, “worry circuit” - damage to 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 ad reduce the “worry circuit”
• Serotonin becomes readily available in receptor cells so that high levels can cause an increase in mood
Ao1: anti-depressants SSRI drugs
• 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 areas and the limbic system which is involved in emotion and memory
- SSRI drugs will help stabilize moods and emotions and improve memory (therefore will reduce compulsive behaviour and checking).
• SSRI drugs are prescribed for 12-16 weeks
• SNRI (Selective Norepinephrine Reuptake Inhibitors) are a new type of drug that increase serotonin and noradrenaline/norepinephrine. These 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. It aims to mobilize the brain and body for action. SNRI’s act on the reuptake of noradrenaline/norepinephrine
Ao3: strength of anti-depressants: SSRI’s
(Soomro - supporting evidence that SSRIs effective treatment)
- reviewed 17 studies that compared SSRI’s to placebo drugs for treating OCD and found that all 17 studies showed that SSRI drugs were more effective than placebos, especially when SSRI’s were combined with CBT
Ao3: strength & weakness of anti-depressants: SSRI’s
(Most effective combined with other other treatments)
- 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
Ao3: strength of anti-depressants: SSRI’s
(Relatively cheap & 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
Ao3: weakness of anti-depressants: SSRI’s
(Don’t 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
Ao3: weakness of anti-depressants: SSRI’s
(Terrible side effects)
- 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
Ao3: weakness of anti-depressants: SSRI’s
(Koran criticised use of drugs & medication to help relieve OCD symptoms)
- Koran stated that drug therapy might be a common or 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 for OCD, and many patients relapse within a few weeks if the medication is stopped
Ao1: benzodiazepines (BZ)
• BZ drugs reduce anxiety and aim to control the action of neurotransmitters.
• Examples of BZ drugs include Valium and Xanax.
• BZ drugs reduce the activity in the central nervous system and reduce brain arousal.
• BZ aim to reduce blood pressure and reduce heart rate
• They aim to increase GABA (Gamma-Amino butyric Acid).
• GABA is a neurotransmitter in the brain that slows down the firing of neurons and makes the person less anxious and calmer. It helps to reduce physiological activity in the body.
Ao1: benzodiazepines (BZ)
• BZ drugs bind to the GABA receptor site of the post synaptic neuron. This increases the flow of chloride ions into the post synaptic neuron. The chloride ions make it more difficult 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.
• BZ also decreases serotonin levels in the brain. This means that the person has lower arousal and reduces anxiety, but they are less happy and are more likely to get depressed
Ao3: strength of BZ drugs
(Very effective at reducing anxiety OCD symptoms)
are used by millions of people worldwide, so they are very good at reducing anxiety and OCD on a global basis
Ao3: strength of BZ drugs
(Work very quickly & 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
Ao3: strength of BZ drugs
(Can be used for short periods of time)
- produce hardly any real serious side effects unlike other types of drugs
- thus, side effects are kept to a minimum with BZ (in the short term) and this is a good point for the OCD patient
Ao3: weakness of BZ drugs
(Long term -several unwanted side effects)
- eg. drowsiness, depression and unpredictable interactions with alcohol
- Patients have a high chance of being involved in accidents
- thus BZ drugs should not be used as a long term treatment for OCD
Ao3: weakness of BZ drugs
(Ashton found long term users became dependent on drug)
- sudden withdrawal of the drug leads to a return of high levels of anxiety and OCD symptoms
- problem of tolerance or drug escalation whereby patients need to take very large doses of the drug in order to reduce their OCD symptoms (if they take the drug for a long period of time)
