ocd: bio treatment - drug therapy

Question 1

what is drug therapy used for?

Answer 1

• those with more severe symptoms, or those who do not respond to CBT which would be recommended for those with mild to moderate OCD

Question 2

what does drug therapy aim to do?

Answer 2

• aims to increase or decrease activity of neurotransmitters in brain
• therefore, drugs have been used with ocd to target different neurotransmitters in the brain especially serotonin

Question 3

what are antidepressants?

Answer 3

• act on the levels of serotonin at the synapse (e.g. selective serotonin reuptake inhibitors)

Question 4

what is SSRI’s? (antidepressants)

Answer 4

• selective serotonin reuptake inhibitors
• work by blocking reuptake of serotonin in pre synaptic neurons in brain, therefore making more serotonin available at the synapse
• means that more serotonin can be passed to the post synaptic neuron, increasing levels of serotonin
• as serotonin is a chemical associated with maintaining mood balance the increased level should positively affect well-being and happiness

Question 5

what examples of drugs are used to raise serotonin levels?

Answer 5

• sertraline and fluoxetine
• dosage used to treat ocd is higher than that used to treat depression

Question 6

how long does it take for the drugs to take effect?

Answer 6

• it can take up to 12 weeks

Question 7

what are anti-anxiety drugs called?

Answer 7

• benzodiazeoines (e.g. Valium) are sometimes used
• work by increasing effectiveness of GABA in regulating anxiety

Question 8

what is GABA?

Answer 8

• amino acid
• acts to lower physiological arousal and return body to resting state following period of heightened arousal or anxiety

Question 9

what are beta blockers?

Answer 9

• e.g. propranolol
• work by blocking stress hormones which are released into blood stream by adrenal glands
• these hormones create physiological symptoms of anxiety such as increased heart rate
• bb’s prevent this physiological response from occurring
• less physiological stress = fewer obsessional thoughts and therefore less compulsive behaviour

Question 10

what are the three drug treatments used to treat OCD?

Answer 10

• antidepressants
• anti-anxiety drugs called benzodiazepines
• beta blockers

Question 11

strengths of drug treatment

Answer 11

• useful, can be used to treat causes of ocd which have not responded to cognitive behaviour therapy
• empirical evidence to show drug treatment can be effective in ocd e.g. Soomro et al 2007 found that antidepressants were more effective than placebo in reducing the symptoms of ocd. Koran et al 2002 found that antidepressant medication had a long-term effect compared to placebo and was better at preventing relapse over an 80 week trial. means that treatment has scientific credibility
• can be combined with cbt, has been shown to raise effectiveness of cbt. supported by POTs study who found adding drugs to cbt improved outcome where cbt was less effective
• modern drug therapy combined with psychological therapy has reduced need to resort to neurosurgery, which had some serious ethical issues

Question 12

weaknesses of drug treatment

Answer 12

• may cause side effects such as nausea and headaches. side effects may limit the usefulness of drugs, as people may not want to take them
• in rare cases, use of medication may increase anxiety rather than decreasing it which can lead to self-harm and increased risk of suicide, therefore active monitoring is always required (can include family or friends who may notice change in behaviour and alert person if necessary)
• drug treatments alone cannot treat most people with ocd; they are most effective when combined with other forms of treatment e.g. cbt
• drug therapy usually needs to last for 12 months before medication can be reduced or discontinued
• patients are likely to relapse if drug treatment is stopped
• individual differences in way that people respond to drugs. e.g. Brody et al 1998 found that differences in metabolism in the right compared to the left orbitofrontal cortex predicts whether person will respond better to cbt or drugs, this information is hard to get hold of without use of PET scanning. further evidence includes Ravizza et al 1995 who found that SSRIs were not effective for 40% of people