OCD - biological approach to treating

Question 1

Drug therapy

Answer 1

Aims to increase or decrease levels of neurotransmitters in the brain or increase/decrease their activity. In the case of psychological disorders such drugs usually affect neurotransmitter levels

Question 2

SSRIs

Answer 2

• Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant used to tackle OCD symptoms
• Work on the serotonin system in the brain
• Serotonin is released from the presynaptic neurone and travels across a synapse to the postsynaptic neurone, then it is reabsorbed by the presynaptic neurone where it is broken down and reused
• By preventing reabsorption and breakdown, SSRIs effectively increase levels of serotonin in the synapse and continue to stimulate the postsynaptic neurone
• This compensates for whatever is wrong with the serotonin system in OCD
• It takes three to four months of daily use for SSRIs to have much of an impact on symptoms

Question 3

Combining SSRIs with other treatments

Answer 3

• Drugs are often used alongside CBT to treat OCD
• The drug reduce a normal persons emotional symptoms such as feeling anxious or depressed
• Means that people with OCD can engage more effectively with CBT
• In some practice some people respond best to CBT alone whilst others benefit more when additionally using drugs
• Occasionally other drugs are prescribed alongside SSRIs

Question 4

Alternatives to SSRIs

Answer 4

• Where an SSRI isn’t effective after three to four months the dose can be increased or it can be combined with other drugs
• Sometimes different antidepressants are tried
• Tricyclics - sometimes used - e.g clomipramine - acts on various systems including the serotonin system where it has the same effect as SSRIs - however it has more side effects than SSRIs so it is generally kept for people who don’t respond well to SSRIs
• SNRIs - different class of antidepressants and, like clomipramine, are a second line of defence for people who don’t respond to SSRIs - SNRIs increase levels of serotonin as well as another different neurotransmitter- noradrenaline

Question 5

Drug therapy - Strength

Answer 5

• Good evidence for its effectiveness
• Evidence to show that SSRIs reduce symptom severity and improve quality of life for people with OCD
• Researcher reviewed 17 studies that compared SSRIs to placebos in the treatment of OCD - all 17 studies showed a better outcome for SSRIs than placebo conditions
• Typically symptoms reduce for around 70% of people taking SSRIs
• Means that drugs appear to be helpful for most people with OCD

Question 6

Drug therapy - Limitation

Answer 6

• Drugs have potentially serious side effects
• Although drugs such as SSRIs help most people, a small minority will get no benefit
• Some people also experience side effects like indigestion, blurred vision and loss of sex drive
• These are usually temporary but they can be quite distressing for people - for a minority they are long lasting
• People taking Tricyclics experience side effects more commonly and they can be more serious - e.g weight gain, aggressiveness and heart related problems
• Means some people have reduced quality of life as a result of taking drugs for OCD